Stintzing Sebastian, Ivanova Boryana, Ricard Ingrid, Jung Andreas, Kirchner Thomas, Tannapfel Andrea, Juette Hendrik, Hegewisch-Becker Susanna, Arnold Dirk, Reinacher-Schick Anke
Department of Medicine III, University Hospital, Ludwig-Maximilians-University, Munich, Germany.
Institute of Pathology, University of Munich, Munich, Germany.
Front Oncol. 2018 Nov 8;8:474. doi: 10.3389/fonc.2018.00474. eCollection 2018.
The EGFR (epithelial growth factor receptor) ligands amphiregulin (AREG) and epiregulin (EREG) have been considered as predictors for EGFR-antibody efficacy. The effect of AREG and EREG expression levels in primary tumor samples on the outcome of bevacizumab-treated patients is unknown. Formalin-fixed paraffin-embedded (FFPE) tumor samples from surgically removed primaries of the AIO KRK-0207 trial have been tested for AREG and EREG expression. The AIO KRK-0207 trial was a randomized phase-3 study to investigate the best maintenance strategy after oxaliplatin/fluoropyrimidine plus bevacizumab induction treatment in patients with mCRC. Association of AREG and EREG levels with outcome parameters were investigated, taking into account RAS and BRAF mutations. A total of 331 tumor samples had measurable AREG and EREG tissue levels. In the total cohort using continuous expression levels, higher logAREG and logEREG levels were associated with a significant longer overall survival (OS) (HR 0.80; = 0.003 and HR 0.78; = 0.001, respectively). The subgroup of BRAF mutant tumors displayed significantly lower AREG and EREG levels compared to wild-type tumors. The prognostic effect of AREG and EREG expression was limited to the double wild-type subpopulation, whereas in the RAS mutant and BRAF mutant subgroups no prognostic effect was detected. Low logAREG and logEREG levels are associated with a shorter OS in oxaliplatin/fluoropyrimidine plus bevacizumab treated patients. As low AREG and EREG level are associated with BRAF mutations, the prognostic value of EREG and AREG levels is limited to the RAS and BRAF wild-type subpopulation.
表皮生长因子受体(EGFR)配体双调蛋白(AREG)和表皮调节素(EREG)被视为EGFR抗体疗效的预测指标。原发性肿瘤样本中AREG和EREG表达水平对贝伐单抗治疗患者预后的影响尚不清楚。对AIO KRK - 0207试验中手术切除的原发性肿瘤的福尔马林固定石蜡包埋(FFPE)样本进行了AREG和EREG表达检测。AIO KRK - 0207试验是一项随机3期研究,旨在调查奥沙利铂/氟嘧啶联合贝伐单抗诱导治疗后转移性结直肠癌(mCRC)患者的最佳维持策略。研究了AREG和EREG水平与预后参数的关联,并考虑了RAS和BRAF突变情况。共有331个肿瘤样本具有可测量的AREG和EREG组织水平。在使用连续表达水平的整个队列中,较高的logAREG和logEREG水平与显著更长的总生存期(OS)相关(HR分别为0.80,P = 0.003和HR为0.78,P = 0.001)。与野生型肿瘤相比,BRAF突变肿瘤亚组的AREG和EREG水平显著更低。AREG和EREG表达的预后作用仅限于双野生型亚群,而在RAS突变和BRAF突变亚组中未检测到预后作用。在接受奥沙利铂/氟嘧啶联合贝伐单抗治疗的患者中,低logAREG和logEREG水平与较短的OS相关。由于低AREG和EREG水平与BRAF突变相关,EREG和AREG水平的预后价值仅限于RAS和BRAF野生型亚群。
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