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Originally published as JCO Early Release 10.1200/JCO.2005.11.890 on March 7 2005

Journal of Clinical Oncology, Vol 23, No 11 (April 10), 2005: pp. 2445-2459
© 2005 American Society of Clinical Oncology.

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OVERVIEW

Critical Update and Emerging Trends in Epidermal Growth Factor Receptor Targeting in Cancer

José Baselga, Carlos L. Arteaga

From the Medical Oncology Service, Vall d'Hebron Research Institute and Vall d'Hebron University Hospital, Barcelona, Spain; and Departments of Medicine and Cancer Biology and Breast Cancer Program, Vanderbilt-Ingram Cancer Center, Nashville, TN

Address reprint requests to José Baselga, MD, Medical Oncology Service, Vall d'Hebron Research Institute and Vall d'Hebron University Hospital, Paseo Vall d'Hebron 119-129, Barcelona 08035, Spain; e-mail: jbaselga{at}vhebron.net.

ABSTRACT

The epidermal growth factor receptor (EGFR) is a receptor tyrosine kinase of the ErbB receptor family that is abnormally activated in many epithelial tumors. The aberrant activation of the EGFR leads to enhanced proliferation and other tumor-promoting activities, which provide a strong rationale to target this receptor family. There are two classes of anti-EGFR agents: monoclonal antibodies (MAbs) directed at the extracellular domain of the receptor and small molecule, adenosine triphosphate–competitive inhibitors of the receptor's tyrosine kinase. Anti-EGFR MAbs have shown antitumor activity in advanced colorectal carcinoma, squamous cell carcinomas of the head and neck, non–small-cell lung cancer (NSCLC) and renal cell carcinomas. The tyrosine kinase inhibitors (TKIs) have a partially different activity profile. They are active against NSCLC, and a specific EGFR inhibitor has shown improvement in survival. Recently, mutations and amplifications of the EGFR gene have been identified in NSCLC and predict for enhanced sensitivity to anti-EGFR TKIs. In addition to specific anti-EGFR TKIs, there are broader acting inhibitors such as dual EGFR HER-2 inhibitors and combined anti-pan-ErbB and antivascular endothelial growth factor receptor inhibitors. Current research efforts are directed at selecting the optimal dose and schedule and identifying predictive factors of response and resistance beyond EGFR gene mutations and/or amplifications. Finally, there is a need for improved strategies to integrate anti-EGFR agents with conventional therapies and to explore combinations with other molecular targeted approaches including other antireceptor therapies, receptor-downstream signaling transduction inhibitors, and targeted approaches interfering with other essential drivers of cancer, such as angiogenesis.

NOTES

Supported by a Spanish Science and Technology Ministry Grant SAF2003-03818 (J.B.), a Breast Cancer Research Foundation Grant (J.B.), National Institutes of Health R01 grant CA80915 (C.L.A.), Breast Cancer Specialized Program of Research Excellence (SPORE) Grant P50 CA98131, and Vanderbilt-Ingram Comprehensive Cancer Center Support Grant P30 CA68485.

Terms in blue are defined in the glossary, found at the end of this issue and online at www.jco.org.

Authors' disclosures of potential conflicts of interest are found at the end of this article.


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F. Rojo, J. Tabernero, J. Albanell, E. Van Cutsem, A. Ohtsu, T. Doi, W. Koizumi, K. Shirao, H. Takiuchi, S. R. Cajal, et al.
Pharmacodynamic Studies of Gefitinib in Tumor Biopsy Specimens From Patients With Advanced Gastric Carcinoma
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Jpn J Clin OncolHome page
W.-C. Chou, S.-F. Huang, K.-Y. Yeh, H.-M. Wang, M.-Y. Liu, J.-J. Hsieh, Y.-C. Cheung, and J. W.-C. Chang
Different Responses to Gefitinib in Lung Adenocarcinoma Coexpressing Mutant- and Wild-Type Epidermal Growth Factor Receptor Genes
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Clin. Cancer Res.Home page
G. R. Simon, C. R. Garrett, S. C. Olson, M. Langevin, I. A. Eiseman, J. J. Mahany, C. C. Williams, R. Lush, A. Daud, P. Munster, et al.
Increased Bioavailability of Intravenous Versus Oral CI-1033, a Pan erbB Tyrosine Kinase Inhibitor: Results of a Phase I Pharmacokinetic Study
Clin. Cancer Res., August 1, 2006; 12(15): 4645 - 4651.
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Clin. Cancer Res.Home page
R. Dziadziuszko, F. R. Hirsch, M. Varella-Garcia, and P. A. Bunn Jr.
Selecting Lung Cancer Patients for Treatment with Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitors by Immunohistochemistry and Fluorescence In situ Hybridization--Why, When, and How?
Clin. Cancer Res., July 15, 2006; 12(14): 4409s - 4415s.
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Clin. Cancer Res.Home page
B. E. Johnson and P. A. Janne
Rationale for a Phase II Trial of Pertuzumab, a HER-2 Dimerization Inhibitor, in Patients with Non-Small Cell Lung Cancer.
Clin. Cancer Res., July 15, 2006; 12(14): 4436s - 4440s.
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Mol. Cell. Biol.Home page
J. J. Bech-Serra, B. Santiago-Josefat, C. Esselens, P. Saftig, J. Baselga, J. Arribas, and F. Canals
Proteomic Identification of Desmoglein 2 and Activated Leukocyte Cell Adhesion Molecule as Substrates of ADAM17 and ADAM10 by Difference Gel Electrophoresis.
Mol. Cell. Biol., July 1, 2006; 26(13): 5086 - 5095.
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J. Mol. Diagn.Home page
Y. Yatabe, T. Hida, Y. Horio, T. Kosaka, T. Takahashi, and T. Mitsudomi
A Rapid, Sensitive Assay to Detect EGFR Mutation in Small Biopsy Specimens from Lung Cancer
J. Mol. Diagn., July 1, 2006; 8(3): 335 - 341.
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Clin. Cancer Res.Home page
R. Asano, Y. Sone, K. Makabe, K. Tsumoto, H. Hayashi, Y. Katayose, M. Unno, T. Kudo, and I. Kumagai
Humanization of the Bispecific Epidermal Growth Factor Receptor x CD3 Diabody and Its Efficacy as a Potential Clinical Reagent.
Clin. Cancer Res., July 1, 2006; 12(13): 4036 - 4042.
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K. Erjala, M. Sundvall, T. T. Junttila, N. Zhang, M. Savisalo, P. Mali, J. Kulmala, J. Pulkkinen, R. Grenman, and K. Elenius
Signaling via ErbB2 and ErbB3 Associates with Resistance and Epidermal Growth Factor Receptor (EGFR) Amplification with Sensitivity to EGFR Inhibitor Gefitinib in Head and Neck Squamous Cell Carcinoma Cells.
Clin. Cancer Res., July 1, 2006; 12(13): 4103 - 4111.
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Cancer Res.Home page
J. Castillo, E. Erroba, M. J. Perugorria, M. Santamaria, D. C. Lee, J. Prieto, M. A. Avila, and C. Berasain
Amphiregulin contributes to the transformed phenotype of human hepatocellular carcinoma cells.
Cancer Res., June 15, 2006; 66(12): 6129 - 6138.
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Clin. Cancer Res.Home page
P. A. Bunn Jr., R. Dziadziuszko, M. Varella-Garcia, W. A. Franklin, S. E. Witta, K. Kelly, and F. R. Hirsch
Biological Markers for Non-Small Cell Lung Cancer Patient Selection for Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitor Therapy.
Clin. Cancer Res., June 15, 2006; 12(12): 3652 - 3656.
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Ann OncolHome page
C. Kollmannsberger, M. Schittenhelm, F. Honecker, J. Tillner, D. Weber, K. Oechsle, L. Kanz, and C. Bokemeyer
A phase I study of the humanized monoclonal anti-epidermal growth factor receptor (EGFR) antibody EMD 72000 (matuzumab) in combination with paclitaxel in patients with EGFR-positive advanced non-small-cell lung cancer (NSCLC)
Ann. Onc., June 1, 2006; 17(6): 1007 - 1013.
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ScienceHome page
J. Baselga
Targeting Tyrosine Kinases in Cancer: The Second Wave.
Science, May 26, 2006; 312(5777): 1175 - 1178.
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JCOHome page
J. Baselga
Is There a Role for the Irreversible Epidermal Growth Factor Receptor Inhibitor EKB-569 in the Treatment of Cancer? A Mutation-Driven Question
J. Clin. Oncol., May 20, 2006; 24(15): 2225 - 2226.
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JCOHome page
E. Calvo and J. Baselga
Ethnic Differences in Response to Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitors
J. Clin. Oncol., May 10, 2006; 24(14): 2158 - 2163.
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Clin. Cancer Res.Home page
S.-W. Han, T.-Y. Kim, Y. K. Jeon, P. G. Hwang, S.-A. Im, K.-H. Lee, J. H. Kim, D.-W. Kim, D. S. Heo, N. K. Kim, et al.
Optimization of Patient Selection for Gefitinib in Non-Small Cell Lung Cancer by Combined Analysis of Epidermal Growth Factor Receptor Mutation, K-ras Mutation, and Akt Phosphorylation
Clin. Cancer Res., April 15, 2006; 12(8): 2538 - 2544.
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T. J. Giordano, A. Y.M. Au, R. Kuick, D. G. Thomas, D. R. Rhodes, K. G. Wilhelm Jr., M. Vinco, D. E. Misek, D. Sanders, Z. Zhu, et al.
Delineation, Functional Validation, and Bioinformatic Evaluation of Gene Expression in Thyroid Follicular Carcinomas with the PAX8-PPARG Translocation.
Clin. Cancer Res., April 1, 2006; 12(7): 1983 - 1993.
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J. R. Tonra, D. S. Deevi, E. Corcoran, H. Li, S. Wang, F. E. Carrick, and D. J. Hicklin
Synergistic antitumor effects of combined epidermal growth factor receptor and vascular endothelial growth factor receptor-2 targeted therapy.
Clin. Cancer Res., April 1, 2006; 12(7): 2197 - 2207.
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JCOHome page
D. A. Reardon, J. N. Rich, H. S. Friedman, and D. D. Bigner
Recent Advances in the Treatment of Malignant Astrocytoma
J. Clin. Oncol., March 10, 2006; 24(8): 1253 - 1265.
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Cancer Res.Home page
D. N. Amin, K. Hida, D. R. Bielenberg, and M. Klagsbrun
Tumor Endothelial Cells Express Epidermal Growth Factor Receptor (EGFR) but not ErbB3 and Are Responsive to EGF and to EGFR Kinase Inhibitors
Cancer Res., February 15, 2006; 66(4): 2173 - 2180.
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The Annals of PharmacotherapyHome page
M. H Nelson and C. R Dolder
Lapatinib: A Novel Dual Tyrosine Kinase Inhibitor with Activity in Solid Tumors
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J. P. Delord, C. Allal, M. Canal, E. Mery, P. Rochaix, I. Hennebelle, A. Pradines, E. Chatelut, R. Bugat, S. Guichard, et al.
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Ann. Onc., December 1, 2005; 16(12): 1889 - 1897.
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B. B.Y. Ma and A. T.C. Chan
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J. Clin. Oncol., October 20, 2005; 23(30): 7758 - 7759.
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R. Hoekstra, H. Dumez, F. A.L.M. Eskens, A. van der Gaast, A. S.T. Planting, G. de Heus, K. C. Sizer, C. Ravera, S. Vaidyanathan, C. Bucana, et al.
Phase I and Pharmacologic Study of PKI166, an Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitor, in Patients with Advanced Solid Malignancies
Clin. Cancer Res., October 1, 2005; 11(19): 6908 - 6915.
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B. E. Johnson and P. A. Janne
Epidermal Growth Factor Receptor Mutations in Patients with Non-Small Cell Lung Cancer
Cancer Res., September 1, 2005; 65(17): 7525 - 7529.
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H. Bonnefoi
'Small' randomised neo-adjuvant chemotherapy trials in breast cancer reporting on pathological response: more harm than good?
Ann. Onc., September 1, 2005; 16(9): 1407 - 1410.
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J. D. Minna, M. J. Peyton, and A. F. Gazdar
Gefitinib Versus Cetuximab in Lung Cancer: Round One
J Natl Cancer Inst, August 17, 2005; 97(16): 1168 - 1169.
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