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- W2202197310 abstract "AACR Annual Meeting-- Apr 12-16, 2008; San Diego, CA4100 Recent advances in our understanding of tumor biology have led to a major shift in the treatment strategy of non-small cell lung cancer (NSCLC) towards targeting aberrant signaling pathways caused by genetic alterations. Epidermal growth factor receptor ( EGFR ) gene mutations are found in a certain subset of patients with NSCLC, and are known to confer the sensitivity to EGFR tyrosine kinase inhibitors (EGFR-TKI), including gefitinib. Preclinical studies have shown that activating EGFR mutations constitutively enhance the signaling of intracellular cascades such as PI3K/Akt and Ras/Raf/MAPK pathways. However, the correlation between EGFR mutations and phosphorylation of EGFR and the activation of its downstream molecules has not been fully evaluated in clinical setting. To better understand these relationship, we studied the EGFR mutation status by direct sequence method as well as by immunohistochemical staining to investigate the protein expression level of EGFR, phosphorylated EGFR (p-EGFR), phosphorylated Akt (p-Akt), and phosphorylated MAPK (p-MAPK) in 93 surgically resected NSCLC patients. Clinical information was also obtained from these individuals to determine the impact of molecular changes on clinical characteristics and survival in patients with NSCLC. The results revealed that there were 37 (40%) patients whose tumor harboring EGFR mutations (1 in exon 18, 22 in exon 19, 14 in exon 21). Protein expression of EGFR, p-EGFR, p-Akt, and p-MAPK was detected in 61 (66%), 27 (29%), 58 (62%), and 41 (44%) patients, respectively. As expected, EGFR mutations were significantly associated with female gender, never-smoking history, and adenocarcinoma histology (P<0.05, each). Of note, p-Akt expression was also associated with female gender and never-smoking history, and it was frequently upregulated in tumors harboring EGFR mutations (P<0.05, each). Phosphorylation of EGFR was closely correlated with the EGFR protein expression (P<0.05), but not with the EGFR mutations. In regard to patient survival, none of the molecular biomarkers was predictive for survival after surgical resection, but p-MAPK expression was predictive for poor prognosis after gefitinib treatment in patients with postoperative recurrence (P<0.05), suggesting the strong linkage between p-MAPK expression and survival benefit from gefitinib. These results could provide new insights into the rational application of inhibitors of Akt and MAPK as single agent or in combination with EGFR-TKI for the treatment of NSCLC." @default.
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- W2202197310 date "2008-05-01" @default.
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- W2202197310 title "Comprehensive analysis of EGFR signaling pathways in non-small cell lung cancer." @default.
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