Concurrent radiotherapy with gefitinib in elderly patients with esophageal squamous cell carcinoma: Preliminary results of a phase II study.

Abstract

The survival rate associated with esophageal cancer is very poor due to diagnosis at advanced stages of disease and insensitivity to chemotherapy. This study investigated the efficacy of gefitinib combination with radiation in 20 elderly patients with esophageal squamous cell carcinoma (ESCC) who were not eligible for platinum-based chemotherapy. Immunohistochemistry was performed to analyze epidermal growth factor receptor (EGFR) expression, and the amplified refractory mutation system was used to detect EGFR mutations. Treatment response was assessed by endoscopy and computed tomography. Treatment toxicity was evaluated using the National Cancer Institute's Common Toxicity Criteria. The data showed that among these 20 patients, 5 experienced a complete response (CR), 13 a partial response (PR), and 2 had stable disease. The overall response rate (CR + PR) was 90%, the median overall survival (OS) was 14.0 months (95% confidence interval [

Linc01014 regulates gefitinib resistance in oesophagus cancer via EGFR‐PI3K‐AKT‐mTOR signalling pathway

“…Mechanism research has identified that gefitinib could sensitize mutation in ESCC cell line KYSE450 via EGFR . However, a phase II study about gefitinib in treating ESCC showed that although the overall response rate could reach 90%, the complete response was only 40% and median progression‐free survival was 7.0 months, suggesting there might be a large room to improve this treatment.…”

“…It is reported that about 40%‐70% of patients with ESCC have presented with high levels of EGFR expression and inhibiting the activity of EGFR might be promising to improve the outcome of patients with ESCC. Gefitinib is a well‐known orally active, reversible and selective EGFR inhibitor applied for ESCC treatment in clinic . However, the resistance of gefitinib has become a new challenge for ESCC treatment with unclear mechanism …”

“…Gefitinib is a wellknown orally active, reversible and selective EGFR inhibitor applied for ESCC treatment in clinic. 7,8 However, the resistance of gefitinib has become a new challenge for ESCC treatment with unclear mechanism. 9 Long non-coding RNAs (lncRNAs) is a class of transcripts without coding capacity at a length of >200 nt and has reported to play critical roles in the pathogenesis and drug resistance of ESCC.…”

Personalized and targeted therapy of esophageal squamous cell carcinoma: an update

“…On the other hand, the outcome of targeted therapy guided by the genomic alterations remains disappointing. Using EGFR as an example, clinical trials of targeted therapy have only shown limited success in improving the overall survival of patients with ESCC . Resistance develops in cancer cells during the treatment, through multiple mechanisms.…”