Prognostic and predictive value of EGFR in head and neck squamous cell carcinoma.
Prognostic and predictive value of EGFR in head and neck squamous cell carcinoma.
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DOI：
10.18632/oncotarget.11413
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发表时间：
2016-11-08
期刊：
影响因子：
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通讯作者：
Perrone F
中科院分区：
文献类型：
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作者：
Bossi P;Resteghini C;Paielli N;Licitra L;Pilotti S;Perrone F
EGFR是头颈部鳞状细胞癌（HNSCC）中广泛研究的生物标志物。本文就EGFR在HNSCC中的预后和预测作用作一综述，重点介绍EGFR在放疗、手术、放疗联合化疗、EGFR抑制剂等治疗方式中的分子变化。我们考虑了不同分子水平的EGFR：蛋白表达、蛋白活化、基因拷贝数、多态性、突变、EGFRvIII表达和EGFR配体表达。仅考虑RT，只有通过定量分析评估时，才有证据支持高EGFR表达的预测和预后作用：这可能有助于选择最能从加速治疗中获益的患者。相反，当治疗是手术，CT和RT的组合时，没有预测性生物标志物可用。对于这种组合治疗，几项研究表明，EGFR表达仅在通过“定量”或至少半定量方法测量时代表良好的预后参数。关于EGFR抑制剂，EGFR表达或基因拷贝数增加均不代表预后/预测因素。如果得到验证，细胞核EGFR、TGFα水平、EGFR磷酸化和多态性可能代表与手术、CT和RT联合治疗相关的其他预后因素，而EGFR多态性和高双调蛋白水平可能对接受EGFR抑制剂治疗的患者具有预后价值。
EGFR is an extensively studied biomarker in head and neck squamous cell carcinoma (HNSCC). In this review, we discuss the prognostic and predictive role of EGFR in HNSCC, focusing on the different molecular alterations in specific treatment modalities such as radiotherapy alone (RT), combination of surgery, RT and chemotherapy (CT), EGFR inhibitors. We considered EGFR at different molecular levels: protein expression, protein activation, gene copy number, polymorphisms, mutation, EGFRvIII expression and EGFR ligand expression. Considering RT alone, evidence supports the predictive and prognostic role of high EGFR expression only when evaluated by quantitative assays: this may help select the patients who can mostly benefit from accelerated treatment. Conversely, no predictive biomarkers are available when treatment is a combination of surgery, CT and RT. For this combined treatment, several studies indicate that EGFR expression represents a good prognostic parameter only when measured by a “quantitative” or at least semi-quantitative method. With respect to EGFR inhibitors, neither EGFR expression nor increased gene copy number represent prognostic/predictive factors. If validated, nuclear EGFR, TGFα levels, EGFR phopshorylation and polymorphisms could represent additional prognostic factors in relation to combination of surgery, CT and RT, while EGFR polymorphisms and high amphiregulin levels could have prognostic value in patients treated with EGFR inhibitors.