Epithelial growth factor receptor (EGFR) mutation status and the treatment of non-small cell lung cancer (NSCLC): A population based quality assurance analysis

Author(s):  
Niels-Chr. G. Hansen ◽  
Christian B. Laursen ◽  
Karin H. Hansen ◽  
Karen E. Olsen
2007 ◽  
Vol 61 (4) ◽  
pp. 487-493 ◽  
Author(s):  
G D Smith ◽  
B E Chadwick ◽  
C Willmore-Payne ◽  
J S Bentz

Background:Activating epidermal growth factor receptor (EGFR) mutations have been implicated in non-small cell lung cancer (NSCLC), and have also been clinically correlated with patient sensitivity to targeted EGFR inhibitors.Aim:To describe a technique for determining EGFR mutation status on archival fine needle aspirate (FNA) specimens from advanced NSCLC patients.Methods:Eleven archival FNA slides from patients with advanced NSCLC were examined for diagnostic material to identify tumour cell-enriched regions. EGFR mutation status was determined using a slide-scrape DNA extraction protocol of selected tumour cell regions on the smear slides, followed by real time PCR and high resolution melt analysis (HRMAA) of EGFR exons 18, 19, 20, and 21, followed by sequence analysis.Results:All DNA samples were successfully amplified by PCR. Three adenocarcinoma patient samples contained EGFR mutations in exon 19 (L747-P753insS). One of the three had an additional exon 19 mutation (A755D).Conclusions:Archival cytology slides from patients with NSCLC can be used to determine EGFR mutation status by PCR, HRMAA, and sequencing. The ability to use archival cytology slides greatly increases the potential material available for molecular analysis in diagnosis and selection of patients for targeted therapeutic agents.


2008 ◽  
Vol 132 (10) ◽  
pp. 1573-1575
Author(s):  
Bruno Murer

Abstract Context.—The development of targeted therapy provides an exciting prospect for treatment of advanced non–small cell lung cancer. In the last few years the epithelial growth factor receptor has emerged as one of the most important targets in very selected patients. Objective.—To review current data on the role of the targeted therapy in advanced non–small cell lung cancer and offer some perspectives for the practitioner. Data Sources.—This review is drawn from pertinent literature and the author's experience. Conclusions.—Despite the remarkable development of targeted therapies in advanced non–small cell lung cancer, there is not yet a real improvement in overall survival. This might be due to (1) the development of primary or secondary resistance to therapy, (2) the biologic method used to select the population to treat, or (3) the molecular status of epithelial growth factor receptor may not be the most important predictor for targeted therapy. The understanding of interactions between epithelial growth factor receptor inhibitors and other molecules will be essential in the development of more effective treatment strategies.


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