1. Clinical efficacy and identification of factors confer resistance to afatinib (tyrosine kinase inhibitor) in EGFR-overexpressing esophageal squamous cell carcinoma
- Author
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Yanni Wang, Chang Liu, Huan Chen, Xi Jiao, Yujiao Wang, Yanshuo Cao, Jian Li, Xiaotian Zhang, Yu Sun, Na Zhuo, Fengxiao Dong, Mengting Gao, Fengyuan Wang, Liyuan Dong, Jifang Gong, Tianqi Sun, Wei Zhu, Henghui Zhang, Lin Shen, and Zhihao Lu
- Subjects
Medicine ,Biology (General) ,QH301-705.5 - Abstract
Abstract Epidermal growth factor receptor (EGFR) is reportedly overexpressed in most esophageal squamous cell carcinoma (ESCC) patients, but anti-EGFR treatments offer limited survival benefits. Our preclinical data showed the promising antitumor activity of afatinib in EGFR-overexpressing ESCC. This proof-of-concept, phase II trial assessed the efficacy and safety of afatinib in pretreated metastatic ESCC patients (n = 41) with EGFR overexpression (NCT03940976). The study met its primary endpoint, with a confirmed objective response rate (ORR) of 39% in 38 efficacy-evaluable patients and a median overall survival of 7.8 months, with a manageable toxicity profile. Transcriptome analysis of pretreatment tumors revealed that neurotrophic receptor tyrosine kinase 2 (NTRK2) was negatively associated with afatinib sensitivity and might serve as a predictive biomarker, irrespective of EGFR expression. Notably, knocking down or inhibiting NTRK2 sensitized ESCC cells to afatinib treatment. Our study provides novel findings on the molecular factors underlying afatinib resistance and indicates that afatinib has the potential to become an important treatment for metastatic ESCC patients.
- Published
- 2024
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