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The significance of the EGFR pathway in malignant pleural mesothelioma

Agarwal, Vijay (Oncologist)


Vijay (Oncologist) Agarwal


Lynn Cawkwell


EGFR, MTOR and COX2 are up regulated in malignant pleural mesothelioma (MPM). In this study we aimed to determine the expression of Lipoxygenase enzymes (LOX), absence of PTEN protein expression and the cytotoxic effect of EGFR, MTOR and COX2 inhibitors in MPM.

Materials and Methods
Immunohistochemical analysis was performed in 93 archival MPM tissue samples to determine the expression of 5-LOX and 12-LOX and PTEN protein. The COX-2 positive cell lines MSTO-211H, NCI-H2052, NCI-H2452 (mesothelioma) and A549 (lung cancer) were utilised. All cell lines were tested for EGFR, KRAS and BRAF mutations. Cells were incubated with Cetuximab, Gefitinib, Rapamycin, Ku0063794 (MTOR kinase inhibitor) and Celecoxib as single agents and in combinations and analysed using the MTS assay.

Positive 5-LOX expression was seen in 73% and positive 12-LOX expression was seen in 83% of MPM samples. PTEN protein expression was absent in 27% of the samples. A549 cells had a KRAS missense mutation at codon 12. No other EGFR, KRAS and BRAF mutations were identified in any of the cell lines. Cetuximab showed 50% cell growth inhibition in MSTO-211H cells at a concentration of 1.6 μM. All other cell lines were resistant to Cetuximab. All cell lines were resistant to Gefitinib. Rapamycin and Ku0063794 demonstrated 50% cell growth inhibition in NCI-H2052, NCI-H2452 and A549. Celecoxib demonstrated 50% cell growth inhibition in all cell lines. Cetuximab and Gefitinib were combined in turn with Rapamycin, Ku0063794 and Celecoxib. Cetuximab when combined with Celecoxib (NCI-H2052, NCI-H2452 and A549 cells) and Ku0063794 (MSTO-211H cells) demonstrated significant growth inhibition.

Our study suggests that 5LOX and 12LOX are expressed in the majority and PTEN protein expression is absent is a significant proportion of MPM tissue samples. Inhibition of MTOR pathway may be an important therapeutic strategy in patients with MPM.


Agarwal, V. (. (2012). The significance of the EGFR pathway in malignant pleural mesothelioma. (Thesis). Hull York Medical School, the University of Hull and the University of York. Retrieved from

Thesis Type Thesis
Deposit Date May 3, 2013
Publicly Available Date Feb 22, 2023
Keywords Medicine
Public URL
Additional Information Hull York Medical School, The University of Hull
Award Date Mar 1, 2012


Thesis (11.2 Mb)

Copyright Statement
© 2012 Agarwal, Vijay (Oncologist). All rights reserved. No part of this publication may be reproduced without the written permission of the copyright holder.

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