Identifying EGFR mutation-positive non-small cell lung cancer

IRESSA (gefitinib) is indicated for the treatment of adult patients with locally advanced or metastatic non‐small cell lung cancer (NSCLC) with activating mutations of epidermal growth factor receptor tyrosine kinase (EGFR‐TK).1

Epidermal growth factor receptor (EGFR) mutations are present in the tumours of approximately 30–41% of Asian and 10–17% of Western patients with NSCLC.2–9

EGFR mutations are more common in:2,10–15

  • never-smokers
  • patients with adenocarcinoma histology
  • females
  • Asian patients.

In patients with advanced NSCLC, EGFR mutation testing can help physicians to select the most appropriate treatment for each patient. A patient‘s EGFR mutation status (positive or negative) can be confirmed via a diagnostic test using a sample of tumour tissue. A number of testing methods are now available that offer a more sensitive alternative to direct DNA sequencing, including targeted techniques that specifically detect the most common EGFR mutations.16 When considering the use of IRESSA treatment, if a tumour sample is not evaluable for EGFR testing, then circulating tumour DNA obtained from a blood (plasma) sample may be used.1

For further information about EGFR mutation diagnostic testing and how to do it, please visit www.EGFR‐mutation.com.

References

  1. IRESSA EU Summary of Product Characteristics. Available at http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Product_Information/human/001016/WC500036358.pdf. Accessed 03 July 2017.
  2. Shigematsu H et al. Clinical and biological features associated with epidermal growth factor receptor gene mutations in lung cancers. J Natl Cancer Inst 2005; 97: 339–346.
  3. Yang SH et al. Mutations in the tyrosine kinase domain of the epidermal growth factor receptor in non-small cell lung cancer. Clin Cancer Res 2005; 11: 2106–2110.
  4. Rosell R et al. Screening for epidermal growth factor receptor mutations in lung cancer. N Engl J Med 2009; 361: 958–967.
  5. Rosell R et al. Erlotinib versus standard chemotherapy as first-line treatment for European patients with advanced EGFR mutation-positive non-small-cell lung cancer (EURTAC): a multicentre, open-label, randomised Phase 3 trial. Lancet Oncol 2012; 13: 239–246.
  6. Douillard J-Y et al. First-line gefitinib in Caucasian EGFR mutation-positive NSCLC patients: a Phase-IV, open-label, single-arm study. Br J Cancer 2014; 110: 55–62.
  7. Han B et al. Determining the prevalence of EGFR mutations in Asian and Russian patients (pts) with advanced non-small-cell lung cancer (aNSCLC) of adenocarcinoma (ADC) and non-ADC histology: IGNITE study. Annals of Oncol 2015; 26(suppl 1): i29–i44.
  8. Reck M et al. Investigating the utility of circulating-free tumour-derived DNA (ctDNA) in plasma for the detection of epidermal growth factor receptor (EGFR) mutation status in European and Japanese patients (pts) with advanced non-small-cell lung cancer (aNSCLC): ASSESS study. Annals of Oncol 2015; 26(suppl 1): i57–i61.
  9. Schuette W et al. EGFR Mutation Status and First-line Treatment in Patients with Stage III/IV Non-small cell Lung Cancer in Germany: An Observational Study. Cancer Epidemiol Biomarkers Prev 2015 [Epub ahead of print].
  10. Cheng L et al. Molecular pathology of lung cancer: key to personalized medicine. Mod Pathol 2012; 25: 347–369.
  11. Sugio K et al. Mutations within the tyrosine kinase domain of EGFR gene specifically occur in lung adenocarcinoma patients with a low exposure of tobacco smoking. Br J Cancer 2006; 94: 896–903.
  12. Matsuo K et al. Risk factors differ for non-small-cell lung cancers with and without EGFR mutation: assessment of smoking and sex by a case-control study in Japanese. Cancer Sci 2007; 98: 96–101.
  13. Gazdar AF. Activating and resistance mutations of EGFR in non-small-cell lung cancer: role in clinical response to EGFR tyrosine kinase inhibitors. Oncogene 2009; 28(Suppl 1): S24–S31.
  14. Dogan S et al. Molecular epidemiology of EGFR and KRAS mutations in 3026 lung adenocarcinomas: higher susceptibility of women to smoking-related KRAS-mutant cancers. Clin Cancer Res 2012; 18: 6169–6177.
  15. Dearden S et al. Mutation incidence and coincidence in non small-cell lung cancer: meta-analyses by ethnicity and histology (mutMap). Ann Oncol 2013; 24: 2371–2376.
  16. Ellison G et al. EGFR mutation testing in lung cancer: a review of available methods and their use for analysis of tumour tissue and cytology samples. J Clin Pathol 2013; 66: 79–89.