Go fish.

You may remember this summer’s published failure of upfront EGFR-targeted therapy (erolitnib in this case) to improve survival over the longtime standard of chemoradiation for advanced esophageal cancer. Neither did second-line gefitinib in the 2014 Cancer Esophagus Gefitinib trial (yes, it appears they named their trial with a string of keywords). But these UK researchers aren’t quite ready to dock their quest of this white whale. As reported at last week’s ASCO GI symposium, a retrospective molecular analysis was performed on path specimens from the gefitinib study to assess gefitinib-response by EGFR-status as determined by fluorescent in situ hybridization (FISH). And voilà! Just like that, the coveted overall survival advantage with EGFR-targeted therapy was finally captured among those with EGFR-high polysomy (and especially) EGFR-amplification. What does this all mean? Probably another--more exclusive--clinical trial. In the meantime, it makes sense to check theEGFR-status on your esophageal patients, particularly those who fail standard upfront therapy.


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