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Targeted Therapy for Targeted Patients: Trastuzumab in Adjuvant Treatment of Non–Small-Cell Lung Cancer

Hacettepe University Faculty of Medicine, Department of Medical Oncology, Ankara, Turkey

Ozden Altundag

Houston, TX

Paolo Morandi

Department of Medical Oncology, S. Bortolo General Hospital, Vicenza, Italy

Mehmet Gunduz

Department of Otolaryngology, Graduate School of Medicine and Dentistry, Okayama University, Shikata, Japan

To the Editor:

We read with great interest the article by Langer et al¹ and editorial by Rosell.² As they state, identification of subset groups of patients who benefit more from trastuzumab therapy must be the ultimate goal. Studies showed that human papilloma virus (HPV) was detected in the minority of the non–small-cell lung cancer patients.³ Recently published data examined the effect of the cooperation between HPV-16 and the tyrosine kinase receptor HER-2/neu on E-cadherin/catenin complex patterns, which normally prevent metastatic processes in tumor tissue, and reported that coexpression of E6/E7 and ErbB-2 downregulates E-cadherin and catenin expression, resulting in neoplastic transformation of primary normal epithelial cells.⁴ Kern et al⁵ stated that patients in early stage with expression of HER-2/neu had inferior survival. In addition to Rosell's proposal for choosing the right patients who benefit more from trastuzumab therapy for lung cancer, we suggest that trastuzumab alone or in combination as an adjuvant treatment in early-stage disease may decrease the relapse rate in patients whose tumor showed HPV-16 E6/E7 positivity and HER-2/neu overexpression.

Authors' Disclosures of Potential Conflicts of Interest

The authors indicated no potential conflicts of interest.

REFERENCES

1. Langer CJ, Stephenson P, Thor A, et al: Trastuzumab in the treatment of advanced non-small-cell lung cancer: Is therea role? Focus on Eastern Cooperative Oncology Group Study 2598. J Clin Oncol 22:1180-1187, 2004[Abstract/Free Full Text]

2. Rosell R: Toward customized trastuzumab in HER-2/neu-overexpressing non-small-cell lung cancers. J Clin Oncol 22:1171-1173, 2004[Free Full Text]

3. Zafer E, Ergun MA, Alver G, et al: Detection and typing of human papillomavirus in non-small cell lung cancer. Respiration 71:88-90, 2004[CrossRef][Medline]

4. Al Moustafa AE, Foulkes WD, Benlimame N, et al: E6/E7 proteins of HPV type 16 and ErbB-2 cooperate to induce neoplastic transformation of primary normal oral epithelial cells. Oncogene 23:350-358, 2004[Medline]

5. Kern JA, Slebos RJ, Top B, et al: C-erB-2 expression and codon 12 K-ras mutations both predict shortened survival for patients with pulmonary adenocarcinomas. J Clin Invest 93:516-520, 1994

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