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Cited by 423HER2/EGFR in Cancer ResearchLung Cancer Treatments and MutationsColorectal Cancer Treatments and Studies

Epidermal growth factor receptor inhibition strategies in oncology

Open access
Harari, P M·2004·Endocrine-Related Cancer
DOI 10.1677/erc.1.00600
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Abstract

Molecular targeting strategies for cancer therapy are distinct from conventional chemotherapy and radiotherapy in their potential to provide increased tumor specificity. One particular molecular target of high promise in oncology is the epidermal growth factor receptor (EGFR). The EGFR is overexpressed, dysregulated or mutated in many epithelial malignancies, and EGFR activation appears important in tumor growth and progression. Advances in signal transduction biology continue to sharpen our understanding regarding specific contributions of EGFR signaling networks to cancer behavior. Two predominant classes of EGFR inhibitors have been developed including monoclonal antibodies (mAbs) that target the extracellular domain of EGFR, such as cetuximab (Erbitux), and small molecule tyrosine kinase inhibitors (TKIs) that target the receptor catalytic domain of EGFR, such as gefitinib (Iressa) and erlotinib (Tarceva). Mechanisms of action for EGFR inhibitors have been investigated in preclinical model systems. Safety, activity, pharmacokinetics and pharmacodynamics have been assessed in clinical trials. The anti-EGFR mAbs and TKIs have partially overlapping toxicity profiles, but distinct routes of administration, serum half-lives and therefore dosing schedules. Both classes of agents show clear antitumor activity, and cetuximab and gefitinib have been recently FDA approved for colorectal and lung cancer indications respectively. However, the absence of survival benefit for EGFR TKIs in combination with chemotherapy in large-scale phase III lung cancer trials in 2003 underscores a major challenge in anti-EGFR oncology therapeutics; namely to identify those tumors and patients that will respond predictably to EGFR inhibitor approaches. Newly identified mutations in the EGFR catalytic domain that appear to confer sensitivity to EGFR TKIs promise to open new doors of investigation regarding response prediction. Advances will also require enhanced molecular understanding of the overall EGFR signaling network, and improved methods to gauge the dependence of individual tumors on EGFR signaling pathways for growth advantage. Results from newly reported phase III trials in 2004 now confirm a survival advantage for the use of EGFR inhibitors in combination with high-dose radiation in head and neck cancer, and in refractory lung cancer respectively. It appears likely that EGFR inhibitors (and other rationally designed molecular growth inhibitors) will play a meaningful role in cancer therapy in the years to come.

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Research works printed but not linked: 13

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Authors
Harari, P. M.
Affiliations
University of Wisconsin–Madison (US)
Corresponding author
Harari, P M
ORCID
Harari, P M
Venue
Endocrine-Related Cancer
Publisher
Bioscientifica
Published
2004-12-01
Volume
11
Issue
4
Pages
689-708
ISSN
  • 1351-0088 (ISSN-L)
  • 1479-6821
DOI
10.1677/erc.1.00600
OpenAlex
W2160425081
Cited by
423
References
94
Citations by year
2026: 3 · 2025: 11 · 2024: 12 · 2023: 9 · 2022: 21 · 2021: 21 · 2020: 20 · 2019: 19 · 2018: 17 · 2017: 15 · 2016: 12 · 2015: 15 · 2014: 14 · 2013: 33 · 2012: 19
FWCI
2.62
Type
journal article
Language
en
Open access
Locations
  • Endocrine Related Cancer (publishedVersion)
  • PubMed (publishedVersion)
Funders
Genentech
Topics
  • Health Sciences › Medicine › Oncology › HER2/EGFR in Cancer Research
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Treatments and Mutations
  • Health Sciences › Medicine › Oncology › Colorectal Cancer Treatments and Studies
Keywords
epidermal growth factor receptor, EGFR inhibitors, cetuximab, gefitinib, erlotinib, tyrosine kinase inhibitors, monoclonal antibodies, EGFR signaling, EGFR mutation, predictive biomarkers, lung cancer, head and neck cancer, colorectal cancer, combination chemotherapy, radiotherapy, targeted therapy
MeSH terms
Cetuximab, Erlotinib Hydrochloride, Gefitinib, Panitumumab, Antibodies, Monoclonal, Antineoplastic Agents, Clinical Trials as Topic, Humans, Neoplasms, Protein-Tyrosine Kinases, Quinazolines, Protein Kinase Inhibitors, Antibodies, Monoclonal, Humanized, ErbB Receptors

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