Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India.
Department of Biochemistry, Maulana Azad Medical College, New Delhi, India.
Asian Pac J Cancer Prev. 2020 Nov 1;21(11):3153-3163. doi: 10.31557/APJCP.2020.21.11.3153.
EGFR over-expression plays a key role in the development and progression of lung cancer. However, its status as a prognostic biomarker for survival outcomes is unclear.
To evaluate the prognostic utility of serum EGFR mRNA expression in Non-Small cell lung cancer (NSCLC) for treatment response and survival.
EGFR mRNA levels were determined in serum using quantitative reverse transcriptase polymerase chain reaction (qRT-PCR). Based on ROC curve, a cut off value of 16.0-fold increase was selected to categorize patients into low EGFR (≤ 16.0) and high EGFR (> 16.0) groups.
A total of 350 subjects were included (78.3% males), with mean (± SD) age of 57.1 (± 11.2) years, and including 247 (70.6%) adenocarcinoma (ADC). Majority (73.1%) had metastatic (stage IV) disease. Patients had higher pre-treatment serum EGFR mRNA levels than controls [median fold-increase (min, max), 16.2 (1.9, 66.7). Serum EGFR mRNA levels significantly reduced in those who achieved objective response and disease control. Significantly longer OS and PFS was observed in subjects having baseline EGFR mRNA expression ≤ 16.0 fold- increase compared to those with > 16.0 fold- increase [median (95% CI) OS: 25.0 (14.9, NR) versus 7.7 (6.3, 8.9) months; HR (95% CI) 2.9 (2.3, 4.0), p < 0.001; and PFS: 9.9 (7.1, 11.5) versus 6.0 (4.1, 7.5) months; HR (95% CI) 1.8 (1.3, 2.4), p < 0.001].
Serum EGFR mRNA expression is a useful parameter for predicting treatment response and survival outcomes in NSCLC.
表皮生长因子受体（EGFR）过表达在肺癌的发生和发展中起着关键作用。然而，其作为生存预后的生物标志物的地位尚不清楚。
评估非小细胞肺癌（NSCLC）患者血清 EGFR mRNA 表达对治疗反应和生存的预后价值。
采用实时定量逆转录聚合酶链反应（qRT-PCR）检测血清 EGFR mRNA 水平。基于 ROC 曲线，选择 16.0 倍的截断值将患者分为低 EGFR（≤16.0）和高 EGFR（>16.0）组。
共纳入 350 例患者（78.3%为男性），平均（±标准差）年龄为 57.1（±11.2）岁，包括 247 例（70.6%）腺癌（ADC）。大多数（73.1%）为转移性（IV 期）疾病。与对照组相比，患者的治疗前血清 EGFR mRNA 水平更高[中位数（最小，最大）倍数增加，16.2（1.9，66.7）]。客观缓解和疾病控制的患者血清 EGFR mRNA 水平显著降低。与 EGFR mRNA 表达基线倍数增加>16.0 的患者相比，基线 EGFR mRNA 表达倍数增加≤16.0 的患者具有更长的总生存期（OS）和无进展生存期（PFS）[中位（95%CI）OS：25.0（14.9，NR）与 7.7（6.3，8.9）个月；HR（95%CI）2.9（2.3，4.0），p<0.001；和 PFS：9.9（7.1，11.5）与 6.0（4.1，7.5）个月；HR（95%CI）1.8（1.3，2.4），p<0.001]。
血清 EGFR mRNA 表达是预测 NSCLC 患者治疗反应和生存预后的有用参数。
