, Volume 4, Issue 4, pp 248-253
Date: 03 Jan 2012

A histology-based algorithm in the molecular diagnosis of mutations of the epidermal growth factor receptor (EGFR)–in non-small-cell lung cancer (NSCLC)*

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Summary

Patients with stage IIIB and IV non-small-cell lung carcinoma (NSCLC) harbouring activating mutations of the epidermal growth factor receptor (EGFR) gene should be treated first-line with gefitinib or erlotinib, EGFR tyrosine kinase inhibitors (TKI). EGF receptor mutations are most common in adenocarcinomas, especially in the non-mucinous type, while they are rare in squamous-cell carcinomas and sarcomatoid carcinomas, and they do not occur in neuroendocrine carcinomas. Therefore, following intense discussion and in consensus with oncologists and pulmonologists, the Pulmonary Pathology Working Group of the Austrian Society of Pathology recommends a-priori EGFR mutation analysis for all adenocarcinoma cases, and for all other NSCLC cases upon clinical request. This will markedly reduce the waiting time for those patients who will most likely gain the greatest benefit from EGFR TKI therapy.

*Recommendations from the Pulmonary Pathology Working Group of the Austrian Society of Pathology.