The family of epidermal growth factor receptors (EGFRs) is overexpressed in many gynecologic malignancies. Extensive preclinical
studies of these receptors demonstrate that they play an important role in supporting the growth of a wide variety of malignancies
and that interruption of receptor function or signaling from these receptors leads to inhibition of tumor growth or in certain
cases tumor regression. Recently, many therapeutic agents targeting this receptor have entered the clinic and phase II clinical
studies have demonstrated activity in lung cancer, colon cancer, and head and neck malignancies. Phase II trials of both small
molecule inhibitors of EGFR and antibody-based inhibitors are underway in both cervical and ovarian cancer and emerging data
suggests that their activity in unselected women with advanced gynecologic malignancies is very modest. Recently, molecular
analysis of lung cancers has identified that the response to small molecule inhibitors of EGFR is highly correlated with activating
mutations within the EGFR. It is possible that these agents will be highly effective in a small subset of patients with gynecologic
malignancies whose tumors are dependent on EGFR signaling, perhaps through an activating mutation in EGFR or its downstream
pathway. Until additional research can identify the subset of patients most likely to benefit from this targeted therapy,
treatment for women with gynecologic malignancies with EGFR inhibitors should be limited to investigational trials. It is
critical that these trials have access to tissue of responding and nonresponding patients so to determine the rational use
of these agents in the treatment of gynecologic malignancies.