Implications of the EGF +61G>A SNP and platelet count on the serum EGF profile: A Critical Review of the proposed predictors for the success of CIMAvax-EGF
Idania González-Pérez1*, Elizabeth Cuétara Lugo1, Elizabeth Reyes Reyes1 and Enrique Iglesias2
1Department of Pharmacology, National Institute of Oncology and Radiobiology, Havana, Cuba
2Department of Vaccines, Center for Genetic Engineering and Biotechnology, Havana, Cuba
*Corresponding Author: Idania González-Pérez, Department of Pharmacology, National Institute of Oncology and Radiobiology, Havana, Cuba.
July 31, 2023; Published: August 10, 2023
Epidermal growth factor (EGF) is an important ligand for the epidermal growth factor receptor (EGFR), the overexpression of which is directly related to the genesis of some epithelial tumors, including non-small cell lung cancer (NSCLC). Therefore, EGF is considered both a marker of cancerous disease and a target for its treatment. However, some methodological problems related to the quantification of this molecule have been affecting its use as a biomarker for disease diagnosis, prognosis, response prediction, and therapy monitoring. CIMAvax-EGF® is a Cuban vaccine for the treatment of NSCLC, targeting EGF. In the last five years, several biomarkers have been proposed for the personalized indication of this vaccine, which have shown limitations in predicting and explaining the response to therapy in some patients. Here we comparatively review these potential predictors of vaccine success and hypothesize that the performance of pretreatment serum EGF concentration, the efficacy biomarker currently in use, is limited by variability in serum EGF quantitation due to: the progressive release of EGF by platelets during serum collection, interindividual differences in platelet count, and different EGF expression caused by the functional single nucleotide polymorphism (SNP) EGF +61G>A. In addition, we discuss the impacts of standardizing serum collection and normalizing serum EGF concentration, on the discriminatory capacity (diagnostic accuracy) of several EGF-related biomarkers described in a more recently conducted prospective exploratory study. The greater discriminatory accuracy of the new variables suggests their better performance in predicting EGF tumor dependence and the response to anti-EGF/EGFR therapies such as the CIMAvax-EGF® vaccine.
Keywords: NSCLC; EGF; +61G>A SNP; EGFR; Diagnostic Accuracy; Predictive Biomarker; CIMAvax-EGF®
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