AIM: Associations between polymorphisms of the epidermal growth factor receptor 
(EGFR) and overall survival in patients with advanced carcinoma of the head and 
neck (HNSCC) receiving cetuximab based palliative treatment, were evaluated.
MATERIALS AND METHODS: HNSCC patients (n=48) received cetuximab +/- 
chemotherapy. Samples for DNA extraction and clinical data were collected 
prospectively. Genotyping of four EGF(R) polymorphisms was performed using 
PCR-based restriction fragment length polymorphism (RFLP).
RESULTS: The median overall survival was 10.6 months. The EGFR-R497K 
polymorphism was significantly associated with overall survival. The presence of 
at least one K-allele was associated with shorter overall survival. The median 
survival in these patients was 6.7 months compared to 13.3 months in the 
patients homozygous for the wild type allele EGFR-497R (p=0.009). Addition of 
chemotherapy to cetuximab, age and EGFR-R497K polymorphism were independent 
predictors of overall survival. Multivariate analysis revealed a hazard ratio 
(HR) for patients with at least one EGFR-497K allele of 3.03 when compared with 
EGFR-497R homozygous patients (p=0.045).
CONCLUSION: The EGFR-R497K polymorphism is a potential predictor for overall 
survival in HNSCC patients treated with cetuximab based therapy in the 
palliative setting.