Keeping FLEXible, EGFR predicts lung cancer survival

Patients with advanced non-small-cell lung cancer (NSCLC), the most common form of lung cancer, don't have many options for treatment and tend not to have a long life expectancy. According to results from Merck KGaA's First-Line ErbituX in lung cancer (FLEX) study, epidermal growth factor receptor (EGFR) could be used as a biomarker for the biological therapy cetuximab (Erbitux) to select the patients most likely to respond to treatment.

Cetuximab is a chimeric (mouse/human) monoclonal antibody targeted to EGFR, used for the treatment of colorectal cancer and squamous cell carcinoma of the head and neck (SCCHN). In the FLEX study, published in Lancet Oncology, the patients with advanced NSCLC whose tumors expressed high levels of EGFR responded better to treatment with a combination of cetuximab and chemotherapy than patients treated with chemotherapy alone.

The patients who were treated with cetuximab and chemotherapy survived for around a year on average, and about a quarter were still alive at two years. Patients getting cetuximab alone survived for about nine and half months on average, and about 15% made it to two years.

An extra two and a half months may not seem that long, but these were patients with advanced disease, and further studies are needed to see the effect on people at earlier stages of the cancer. Testing for EGFR could be used to predict which patients will respond best to cetuximab--on the flip side, it could also help to save healthcare providers' money by suggesting which patients would not respond to an expensive biological therapy.

- read the article in MedPage Today
- see the abstract from Lancet Oncology