West Asia Organization for Cancer Prevention (WAOCP), APOCP's West Asia Chapter. Asian Pacific Journal of Cancer Prevention 1513-7368 21 11 2020 11 01 Measurement of Serum EGFR mRNA Expression is a Reliable Predictor of Treatment Response and Survival Outcomes in Non- Small Cell Lung Cancer 3153 3163 89333 10.31557/APJCP.2020.21.11.3153 EN Anant Mohan Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India. 0000000223839437 Ashraf Ansari Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India. Mirza Masroor Department of Biochemistry, Maulana Azad Medical College, New Delhi, India. Alpana Saxena Department of Biochemistry, Maulana Azad Medical College, New Delhi, India. R M Pandey Department of Biostatistics, All India Institute of Medical Sciences, New Delhi. Ashish Upadhyay Department of Biostatistics, All India Institute of Medical Sciences, New Delhi. Kalpana Luthra Department of Biostatistics, All India Institute of Medical Sciences, New Delhi. G C Khilnani Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India. Deepali Jain Department of Pathology, All India Institute of Medical Sciences, New Delhi, India. Rakesh Kumar Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India. Randeep Guleria Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India. Journal Article 2019 04 28 Background: EGFR over-expression plays a key role in the development and progression of lung cancer. However, its status as a prognostic biomarker for survival outcomes is unclear. Objectives: To evaluate the prognostic utility of serum EGFR mRNA expression in Non-Small cell lung cancer (NSCLC) for treatment response and survival. Methods: EGFR mRNA levels were determined in serum using quantitative reverse transcriptase polymerase chain reaction (qRT-PCR). Based on ROC curve, a cut off value of 16.0-fold increase was selected to categorize patients into low EGFR (≤ 16.0) and high EGFR (> 16.0) groups. Results: A total of 350 subjects were included (78.3% males), with mean (± SD) age of 57.1 (± 11.2) years, and including 247 (70.6%) adenocarcinoma (ADC). Majority (73.1%) had metastatic (stage IV) disease. Patients had higher pre-treatment serum EGFR mRNA levels than controls [median fold-increase (min, max), 16.2 (1.9, 66.7). Serum EGFR mRNA levels significantly reduced in those who achieved objective response and disease control. Significantly longer OS and PFS was observed in subjects having baseline EGFR mRNA expression ≤ 16.0 fold- increase compared to those with > 16.0 fold- increase [median (95% CI) OS: 25.0 (14.9, NR) versus 7.7 (6.3, 8.9) months; HR (95% CI) 2.9 (2.3, 4.0), p < 0.001; and PFS: 9.9 (7.1, 11.5) versus 6.0 (4.1, 7.5) months; HR (95% CI) 1.8 (1.3, 2.4), p < 0.001]. Conclusion: Serum EGFR mRNA expression is a useful parameter for predicting treatment response and survival outcomes in NSCLC. https://journal.waocp.org/article_89333_bc43ae1f8c4bd862ca6d35888612d015.pdf