Department of Dermatology, Hospital General Dr. Manuel Gea Gónzalez, Mexico City, Mexico.
Department of Oncology, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, Mexico.
Thorac Cancer. 2020 Nov;11(11):3243-3251. doi: 10.1111/1759-7714.13657. Epub 2020 Oct 5.
A relationship between the EGFR signaling pathway expression in skin and the use of targeted cancer therapies has been previously demonstrated. Consistent evidence to support the use of skin biopsies as a surrogate for therapeutic evaluation is needed. The purpose of this study was to establish the relationship between the expression of EGFR signaling pathway markers in skin samples from EGFR-mutated metastatic lung adenocarcinoma patients and their response to tyrosine kinase inhibitors.
This was a prospective single blind analysis of 35 skin biopsies from 31 patients with confirmed advanced EGFR-mutated lung adenocarcinoma. Immunohistochemistry was performed: EGFR, p27, Ki67, STAT3 and MAPK, as well as H&E histopathological analysis, in order to determine their treatment response to tyrosine kinase inhibitors.
EGFR, Ki67, STAT3, stratum corneum thickness (number of layers and millimeters) from skin samples had a statistical correlation with an adequate treatment response (P = 0.025, 0.015, 0.017, 0.041, 0.039 respectively). EGFR, p27 and number of layers of the stratum corneum were related to a better median progression-free survival (P = 0.025 and P = 0.030).
The relationship between EGFR pathway inhibition in the skin and oncological outcomes obtained explains the parallel biological effects of tyrosine kinase inhibitors. We hope that our work incites future research to help validate and assess the use of these markers as potential prognostic and predictive factors.
先前已经证明，表皮生长因子受体（EGFR）信号通路在皮肤中的表达与靶向癌症治疗的应用之间存在关联。需要有一致性的证据来支持将皮肤活检用作治疗评估的替代物。本研究的目的是确定 EGFR 突变型转移性肺腺癌患者皮肤样本中 EGFR 信号通路标志物的表达与对酪氨酸激酶抑制剂（TKI）的反应之间的关系。
这是对 31 例经证实的晚期 EGFR 突变型肺腺癌患者的 35 例皮肤活检进行的前瞻性单盲分析。进行了免疫组织化学检测：表皮生长因子受体（EGFR）、p27、Ki67、STAT3 和 MAPK，以及 H&E 组织病理学分析，以确定其对 TKI 的治疗反应。
皮肤样本中的 EGFR、Ki67、STAT3、角质层厚度（层数和毫米）与充分的治疗反应具有统计学相关性（P=0.025、0.015、0.017、0.041、0.039 分别）。EGFR、p27 和角质层的层数与中位无进展生存期（PFS）更好相关（P=0.025 和 P=0.030）。
皮肤中 EGFR 通路抑制与获得的肿瘤学结果之间的关系解释了酪氨酸激酶抑制剂的平行生物学效应。我们希望我们的工作能够激发未来的研究，以帮助验证和评估这些标志物作为潜在的预后和预测因素的用途。
