A novel use of positron emission tomography (PET) scans predicts which patients with lung cancer will respond to epidermal growth factor receptor (EGFR) inhibitors, further personalizing cancer care with non-invasive methods.  These results were recently presented at the 14th World Conference on Lung Cancer, sponsored by the International Association for the Study of Lung Cancer.

The EGFR pathway is involved in cellular growth and replication.  In a significant portion of cancers, the EGFR pathway contains a mutation and does not function normally. Novel medications for cancer, referred to as EGFR inhibitors, reduce or stop unchecked cellular growth through this pathway among patients with EGFR mutations.

Patients with lung cancer often undergo testing to determine whether they have mutations within their EGFR pathways, ultimately establishing whether EGFR inhibitors may be effective treatment. This testing involves invasive methods to remove cancerous tissue which undergoes subsequent laboratory testing.

Researchers from Amsterdam recently conducted a clinical trial to evaluate the accuracy with which PET scans using Tarceva® (erlotinib), an EGFR inhibitor, could predict responses to treatment with the drug. The trial included 10 patients with non-small cell lung cancer (NSCLC) who initially underwent standard laboratory testing for EGFR mutations. Five patients had EGFR mutations and 5 patients did not. The patients then underwent PET scanning with radiolabeled Tarceva.

Patients whose cancer absorbed high levels of the radiolabeled Tarceva during the scan were the only patients who responded to subsequent therapy with Tarceva.

Dr. Idris Bahce, the principle investigator of the study, stated that “This is an important finding, as it indicates that this new imaging PET technique may be a non-invasive predictive marker that identifies NSCLC patients who benefit from treatment with [EGFR inhibitors].” Although this was a small, preliminary study, these results provide a novel approach to a personalized and less invasive method of determining which patients will respond to treatment with EGFR inhibitors. Further studies evaluating this type of procedure are being planned.

Reference: Bahce I, et al. In vivo selection of non-small cell lung cancer patients with activating mutations in the tumor epidermal growth factor receptor using [11C]erlotinib and positron emission tomography. Presented at the 14th World Conference on Lung Cancer. July 3-7, 2011. Amsterdam, Netherlands. Abstract PRS.5.

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