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Article Open Access

Impact of EMT in stage IIIB/IV NSCLC treated with erlotinib and bevacizumab when compared with cisplatin, gemcitabine and bevacizumab

  • Authors:
    • Matthias Villalobos
    • Piotr Czapiewski
    • Niels Reinmuth
    • Jürgen R. Fischer
    • Stefan Andreas
    • Cornelius Kortsik
    • Monika Serke
    • Martin Wolf
    • Petra Neuser
    • Alexander Reuss
    • Philipp A. Schnabel
    • Michael Thomas
  • View Affiliations / Copyright

    Affiliations: Department of Thoracic Oncology, University Hospital Heidelberg and Translational Lung Research Center Heidelberg, Member of The German Center for Lung Research, D‑69126 Heidelberg, Germany, Department of Pathology, Otto‑Von‑Guericke University Magdeburg, D‑39120 Magdeburg, Germany, Department of Pneumology/Oncology, Asklepios Fachkliniken München‑Gauting, D‑82131 Gauting, Germany, Department of Oncology, Lungenklinik Löwenstein, D‑74245 Löwenstein, Germany, Department of Pneumology, Lungenfachklinik Immenhausen, D‑34376 Immenhausen, Germany, Department of Pneumology, Katholisches Klinikum Mainz, D‑55131 Mainz, Germany, Department of Pneumology/Oncology, Lungenklinik Hemer, D‑58656 Hemer, Germany, Medical Clinic IV, Department of Hematology/Oncology, Klinikum Kassel, D‑34112 Kassel, Germany, Coordinating Center for Clinical Trials, University Marburg, D‑35043 Marburg, Germany, Institute of Pathology, University of Homburg Saar, D‑66421 Homburg, Germany
    Copyright: © Villalobos et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Pages: 4891-4900
    |
    Published online on: March 15, 2019
       https://doi.org/10.3892/ol.2019.10153
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Abstract

The aim of the present study was to assess the expression of epithelial‑mesenchymal transition biomarkers (E‑cadherin and vimentin) and their potential significance as prognostic markers in patients with stage IIIB/IV non‑squamous non‑small cell lung cancer (NSCLC) enrolled in the INNOVATIONS trial, receiving treatment with either erlotinib/bevacizumab (EB) or cisplatin/gemcitabine/bevacizumab (PGB). The tumor tissues of 104 patients were retrospectively analyzed using immunohistochemistry to assess the expression of E‑cadherin and vimentin. The distribution between the treatment arms was 46 patients in the EB‑arm and 58 in the PGB‑arm. Comparing the treatment arms according to E‑cadherin and vimentin expression, the analysis revealed that progression‑free survival (PFS) was increased in the PGB treatment group when compared with EB treatment in patients with low expression of E‑cadherin [hazard ratio (HR)=0.353; 95% confidence interval (CI) 0.189‑ 0.658; log‑rank P=0.0007] and in those with high expression of vimentin [HR=0.276 (95% CI, 0.115‑ 0.659), log‑rank P=0.0021]. In patients that exhibited high E‑cadherin and were negative for vimentin, there was no difference in the PFS between the PGB and EB treatment groups. In conclusion, in non‑squamous NSCLC with downregulated E‑cadherin and upregulated vimentin, the efficacy of chemotherapy with PGB was superior compared with EB; but the same effect was not observed in patients with high E‑cadherin and low vimentin. Although increased PFS was observed in patients with PGB treatment compared with EB treatment in the whole analysis populations, in the subgroup of patients with the mesenchymal phenotype, no prognostic or predictive value of either biomarker could be identified. The potential role of bevacizumab in overcoming chemotherapy resistance in the population with the mesenchymal phenotype has to be further explored.
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Copy and paste a formatted citation
Spandidos Publications style
Villalobos M, Czapiewski P, Reinmuth N, Fischer JR, Andreas S, Kortsik C, Serke M, Wolf M, Neuser P, Reuss A, Reuss A, et al: Impact of EMT in stage IIIB/IV NSCLC treated with erlotinib and bevacizumab when compared with cisplatin, gemcitabine and bevacizumab. Oncol Lett 17: 4891-4900, 2019.
APA
Villalobos, M., Czapiewski, P., Reinmuth, N., Fischer, J.R., Andreas, S., Kortsik, C. ... Thomas, M. (2019). Impact of EMT in stage IIIB/IV NSCLC treated with erlotinib and bevacizumab when compared with cisplatin, gemcitabine and bevacizumab. Oncology Letters, 17, 4891-4900. https://doi.org/10.3892/ol.2019.10153
MLA
Villalobos, M., Czapiewski, P., Reinmuth, N., Fischer, J. R., Andreas, S., Kortsik, C., Serke, M., Wolf, M., Neuser, P., Reuss, A., Schnabel, P. A., Thomas, M."Impact of EMT in stage IIIB/IV NSCLC treated with erlotinib and bevacizumab when compared with cisplatin, gemcitabine and bevacizumab". Oncology Letters 17.6 (2019): 4891-4900.
Chicago
Villalobos, M., Czapiewski, P., Reinmuth, N., Fischer, J. R., Andreas, S., Kortsik, C., Serke, M., Wolf, M., Neuser, P., Reuss, A., Schnabel, P. A., Thomas, M."Impact of EMT in stage IIIB/IV NSCLC treated with erlotinib and bevacizumab when compared with cisplatin, gemcitabine and bevacizumab". Oncology Letters 17, no. 6 (2019): 4891-4900. https://doi.org/10.3892/ol.2019.10153
Copy and paste a formatted citation
x
Spandidos Publications style
Villalobos M, Czapiewski P, Reinmuth N, Fischer JR, Andreas S, Kortsik C, Serke M, Wolf M, Neuser P, Reuss A, Reuss A, et al: Impact of EMT in stage IIIB/IV NSCLC treated with erlotinib and bevacizumab when compared with cisplatin, gemcitabine and bevacizumab. Oncol Lett 17: 4891-4900, 2019.
APA
Villalobos, M., Czapiewski, P., Reinmuth, N., Fischer, J.R., Andreas, S., Kortsik, C. ... Thomas, M. (2019). Impact of EMT in stage IIIB/IV NSCLC treated with erlotinib and bevacizumab when compared with cisplatin, gemcitabine and bevacizumab. Oncology Letters, 17, 4891-4900. https://doi.org/10.3892/ol.2019.10153
MLA
Villalobos, M., Czapiewski, P., Reinmuth, N., Fischer, J. R., Andreas, S., Kortsik, C., Serke, M., Wolf, M., Neuser, P., Reuss, A., Schnabel, P. A., Thomas, M."Impact of EMT in stage IIIB/IV NSCLC treated with erlotinib and bevacizumab when compared with cisplatin, gemcitabine and bevacizumab". Oncology Letters 17.6 (2019): 4891-4900.
Chicago
Villalobos, M., Czapiewski, P., Reinmuth, N., Fischer, J. R., Andreas, S., Kortsik, C., Serke, M., Wolf, M., Neuser, P., Reuss, A., Schnabel, P. A., Thomas, M."Impact of EMT in stage IIIB/IV NSCLC treated with erlotinib and bevacizumab when compared with cisplatin, gemcitabine and bevacizumab". Oncology Letters 17, no. 6 (2019): 4891-4900. https://doi.org/10.3892/ol.2019.10153
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