Impact of menopausal status and HER-2/neu protein on efficacy of EGFR-TKI in EGFR mutant patients with non-small cell lung cancer

• Published in: Journal of Cancer Vol. 9; no. 17; pp. 2987 - 2993
• Main Authors: Yin, Zi-Jun, Tu, Hai-Yan, Fu, Ming, Zhong, Wen-Zhao, An, She-Juan, Yan, Hong-Hong, Chen, Hua-Jun, Lin, Hui-Ran, Wu, Yi-Long
• Format: Journal Article
• Language: English
• Published: Australia Ivyspring International Publisher 01.01.2018
• Subjects: Research Paper; human epidermal growth factor receptor-2; HER-2/neu; menopausal status; efficacy; non-small-cell lung cancer
• ISSN: 1837-9664; 1837-9664
• DOI: 10.7150/jca.25679

Clinical studies have confirmed epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs) used in lung cancer patients with mutations can obtain a better result, but still part of the patients with poor efficacy. mutation is highly related to female, nonsmoking and adenocarcinoma. Thus, we hypothesize that estrogen and circulating HER-2/neu protein might influence the efficacy of EGFR-TKIs in mutant patients with non-small cell lung cancer. HER-2/neu expression level of 357 eligible patients in its peripheral serum was determined using ELISA. The median progression-free survival (PFS) in five groups (premenopausal group, perimenopause group, peri to postmenopausal group, postmenopausal group and control group) was statistically difference ( = 0.025). Premenopausal group could predict the efficacy of EGFR-TKI ( = 2.45, 95% CI = 1.42-4.23, = 0.001). No statistical significance was found in median overall survival (OS) among five groups. Optimal diagnostic cut off value of HER-2/neu was set at 47.5 ng/ml, with = 0.0607. As the cutoff value to 47.5 ng/ml division, concentrations and menopausal status was of no significant difference ( = 0.874). PFS of the group below 47.5 ng/ml was significantly longer than that of the group over 47.5 ng/ml ( = 0.000). HER-2/neu concentration was positively correlated with optimal efficacy ( = 0.042). HER-2/neu concentration over than 47.5 ng/ml was a risk factor of EGFR-TKI prognosis. Premenopausal status is an independent predictor of EGFR-TKI curative effect and circulating HER-2/neu protein is an independent prognostic factor in patients with advanced NSCLC.