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A phase II and pharmacodynamic study of gefitinib in patients with refractory or recurrent epithelial ovarian cancer†
Version of Record online: 1 MAR 2007
Published 2007 American Cancer Society
Volume 109, Issue 7, pages 1323–1330, April 2007
How to Cite
Posadas, E. M., Liel, M. S., Kwitkowski, V., Minasian, L., Godwin, A. K., Hussain, M. M., Espina, V., Wood, B. J., Steinberg, S. M. and Kohn, E. C. (2007), A phase II and pharmacodynamic study of gefitinib in patients with refractory or recurrent epithelial ovarian cancer. Cancer, 109: 1323–1330. doi: 10.1002/cncr.22545
This is a US government work and, as such, is in the public domain in the United States of America.
- Issue online: 19 MAR 2007
- Version of Record online: 1 MAR 2007
- Manuscript Accepted: 8 DEC 2006
- Manuscript Received: 29 NOV 2006
- Intramural Research Program of the National Cancer Institute
- Center for Cancer Research
- Ovarian Cancer Specialized Program in Research Excellence P50. Grant Number: CA83638
- Pennsylvania Department of Health
- ovarian cancer;
- epidermal growth factor receptor;
- protein array
The primary objective of this study was to evaluate the biochemical effects of gefitinib on its target signal-transduction pathways in patients with recurrent epithelial ovarian cancer (EOC). The secondary objectives included assessing clinical activity and toxicity and determining the association between biochemical and clinical outcomes.
Twenty-four heavily pretreated patients with EOC who had good end-organ function and performance status and who had measurable disease received gefitinib 500 mg daily. Prospectively planned core-needle tumor biopsies were obtained before treatment and after 4 weeks. Protein expression of total and phosphorylated (p) epidermal growth factor receptor (EGFR), protein kinase B (AKT), and extracellular regulated kinase (ERK) was quantified in microdissected tumor cells using tissue lysate array proteomics.
All tumor samples had detectable levels of EGFR and p-EGFR. A decrease in the quantity of both EGFR and p-EGFR was observed with gefitinib therapy in >50% of patients. This was not associated with clinical benefit, nor were responses observed. However, trends for increased gastrointestinal and skin toxicity were observed with greater phosphorylation or quantities of EGFR, ERK, and AKT in tumor samples (P ≤ .05). Gefitinib had limited clinical activity as monotherapy despite documented target inhibition.
The results from this study demonstrated that gefitinib inhibited the phosphorylation of EGFR in EOC tumor cells, providing proof of target in a clinical setting. Combinatorial therapy with molecular therapeutics against complementary targets may prove successful. Cancer 2007. Published 2007 by the American Cancer Society.