Exonic expression variations of EGFR and KRAS in small bronchoscopic biopsies from patients with advanced non-small cell lung cancer treated by combined bevacizumab/erlotinib therapy followed by platinum-based chemotherapy at disease progression: A multicenter phase II trial SAKK19/05.

Authors

null

M. H. Brutsche

Division of Pneumology, Kantonsspital St. Gallen, St. Gallen, Switzerland

M. H. Brutsche , M. Frueh , S. Crowe , K. J. Na , C. Droege , D. C. Betticher , R. von Moos , F. Zappa , M. Pless , L. Bubendorf , F. Baty

Organizations

Division of Pneumology, Kantonsspital St. Gallen, St. Gallen, Switzerland, Medical Oncology, Kantonsspital St. Gallen, St. Gallen, Switzerland, Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland, Department of Medical Oncology, University Hospital, Basel, Switzerland, Hospital of Fribourg, Fribourg, Switzerland, Medical Oncology, Kantonsspital Graubuenden, Chur, Switzerland, Oncology Institute of Southern Switzerland, Lugano, Switzerland, Kantonsspital Winterthur, Winterthur, Switzerland, University Hospital, Basel, Switzerland, Kantonsspital St. Gallen, St. Gallen, Switzerland

Research Funding

Pharmaceutical/Biotech Company

Background: The Swiss Group for Clinical Cancer Research (SAKK) investigated the activity of bevacizumab/erlotinib (BE) in 101 treatment-naïve non-squamous stage IIIB and IV non-small cell lung cancer (NSCLC) patients in a single arm phase II trial (SAKK 19/05). We explored the effect of BE focusing on the exon intensity levels of EGFR and KRAS, a target and a prognostic gene, in these patients. Methods: The genome-wide exon expression level of 42 bronchoscopic biopsies was investigated using Affymetrix exon arrays. Unsupervised multivariate approaches, including principal component analysis (PCA) and hierarchical clustering were used to describe the exonic variations within EGFR and KRAS among patients having various EGFR/KRAS mutational status. All analyses were blinded for the mutational status and clinical outcome. Results: All probe sets measured within EGFR (n=451) and KRAS (n=261) were extracted for the purpose of the analysis. Fifty-one and 11 exonic probe sets were available within EGFR and KRAS respectively. PCA revealed a gradient of expression among patients which was homogeneous among different EGFR exons (average within-patient coefficient of variation=0.28), whereas more complex exonic variations were found within KRAS (average within-patient coefficient of variation=0.43). In contrast to KRAS, there was a trend showing an association between gender and the expression of EGFR (p=0.06). Conclusions: Using exon arrays, it was possible to assess the exonic expression level of 2 key genes involved in non-squamous NSCLC growth pathways. EGFR expression level was homogeneous among exons, advocating independence between the exon intensity level and the patient mutational status. Conversely, KRAS showed a significantly larger within-patient variation in the exonic expression level. We hypothesize that the exonic heterogeneity within KRAS provides additional prognostic information complementary to the patients’ mutational status. These results will be provided after the unblinding of the trial.

Disclaimer

This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org

Abstract Details

Meeting

2011 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Tumor Biology

Track

Tumor Biology

Sub Track

Prognostic Factors

Clinical Trial Registration Number

NCT00354549

Citation

J Clin Oncol 29: 2011 (suppl; abstr 10570)

Abstract #

10570

Poster Bd #

24E

Abstract Disclosures