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Original Research: Lung Cancer |

Rationale for Treatment of Metastatic Squamous Cell Carcinoma of the Lung Using Fibroblast Growth Factor Receptor InhibitorsFibroblast Growth Factor Receptor-1 in Lung Cancer

Friederike Göke, MD; Alina Franzen, BS; Roopika Menon, MSc; Diane Goltz, MD; Robert Kirsten; Diana Boehm, BS; Wenzel Vogel, BS; Antonia Göke, BS; Veit Scheble, MD; Joerg Ellinger, MD; Ulrich Gerigk, MD; Falko Fend, MD; Patrick Wagner, MD; Andreas Schroeck, MD; Sven Perner, MD
Author and Funding Information

From the Institute of Pathology (Drs Göke, Goltz, and Perner and Mss Franzen and Menon), Institute of Prostate Cancer Research (Drs Göke, Schroeck, and Perner; Mss Franzen, Menon, Boehm, and Göke; and Messrs Kirsten and Vogel), Department of Head and Neck Surgery (Dr Schroeck), Department of Urology (Dr Ellinger), and Department of Thorax Surgery (Dr Gerigk), Affiliated Malteser Hospital, University Hospital of Bonn, Bonn, Germany; Department of Hematology and Oncology (Dr Scheble) and Institute of Pathology (Dr Fend), University Hospital of Tuebingen, Tuebingen, Germany; and Division of Surgical Oncology (Dr Wagner), University of Pittsburgh Medical Center, Pittsburgh, PA.

Correspondence to: Sven Perner, MD, Institute of Pathology, University Hospital of Bonn, Sigmund-Freud-Strasse 25, 53127 Bonn, Germany; e-mail: sven.perner1972@gmail.com


Funding/Support: This study was supported by a grant of the Rudolph-Becker-Foundation to Dr Perner and by a scholarship of the German Cancer Aid [Deutsche Krebshilfe #110081] to Ms Göke.

Dr Göke and Ms Franzen contributed equally to this work.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2012;142(4):1020-1026. doi:10.1378/chest.11-2943
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Background:  We previously identified amplification of the fibroblast growth factor receptor 1 gene (FGFR1) as a potential therapeutic target for small-molecule inhibitor therapy in squamous cell lung cancer (L-SCC). Currently, clinical phase I trials are underway to examine whether patients with FGFR1-amplified L-SCC benefit from a targeted therapy approach using small-molecule inhibitors. Because most patients with lung cancer present with metastatic disease, we investigated whether lymph node metastases in L-SCC share the FGFR1 amplification status of their corresponding primary tumor.

Methods:  The study cohort consisted of 72 patients with L-SCC, 39 with regional lymph node metastases. Tissue microarrays were constructed from formalin-fixed, paraffin-embedded tissue of the primary tumors and, where present, of the corresponding lymph node metastasis. A biotin-labeled target probe spanning the FGFR1 locus (8p11.22-23) was used to determine the FGFR1 amplification status by fluorescence in situ hybridization.

Results:  FGFR1 amplification was detected in 16% (12 of 72) of all primary L-SCCs. In metastatic tumors, 18% (seven of 39) of the lymph node metastases displayed FGFR1 amplification with an exact correlation of FGFR1 amplification status between tumor and metastatic tissue.

Conclusions:  FGFR1 amplification is a common genetic event occurring at a frequency of 16% in L-SCCs. Moreover, lymph node metastases derived from FGFR1-amplified L-SCCs also exhibit FGFR1 amplification. Therefore, we suggest that the FGFR1 amplification is a clonal event in tumor progression. Beyond this biologically relevant observation, the findings carry potential therapeutic implications in that small-molecule inhibitors may be applicable to the treatment of a subset of patients with metastatic L-SCC.

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