Cancer Chemotherapy and Pharmacology

, Volume 74, Issue 4, pp 661–665 | Cite as

Should EGFR mutations be tested in advanced lung squamous cell carcinomas to guide frontline treatment?

  • Chao-Hua Chiu
  • Teh-Ying Chou
  • Chi-Lu Chiang
  • Chun-Ming Tsai
Review Article


There is no argument over using epidermal growth factor receptor (EGFR) mutation status to guide the frontline treatment for advanced lung adenocarcinoma (LADC); however, the role of the testing in lung squamous cell carcinoma (LSQC) remains controversial. Currently, the guidelines/consensus statements regarding EGFR mutation testing in LSQC are not consistent among different oncology societies. American Society of Clinical Oncology recommends performing EGFR mutation testing in all patients; European Society for Medical Oncology, College of American Pathologists/International Association for the Study of Lung Cancer/Association for Molecular Pathology, and National Comprehensive Cancer Network suggest for some selected group. EGFR mutation is rarely found in LSQC; however, more importantly, it is not a valid predictive biomarker for EGFR tyrosine kinase inhibitors (EGFR-TKI) in LSQC as it has been shown in LADC. Available data showed that the response rate and progression-free survival in EGFR mutant LSQC patients treated with EGFR-TKI are not better than that observed in patients treated with platinum-doublet chemotherapy in the first-line setting. Therefore, in contrast to advanced LADC, EGFR mutation testing may not be necessarily performed upfront in advanced LSQC because not only the mutation rate is low, but also the predictive value is insufficient. For LSQC patients with known sensitizing-EGFR mutations, both conventional chemotherapy and EGFR-TKI are acceptable frontline treatment options.


Epidermal growth factor receptor Nonsmall cell lung cancer Squamous cell carcinoma Tyrosine kinase inhibitor 


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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Chao-Hua Chiu
    • 1
    • 2
    • 3
  • Teh-Ying Chou
    • 1
    • 4
  • Chi-Lu Chiang
    • 3
  • Chun-Ming Tsai
    • 2
    • 3
  1. 1.Institute of Clinical MedicineNational Yang-Ming UniversityTaipeiTaiwan
  2. 2.Department of MedicineNational Yang-Ming UniversityTaipeiTaiwan
  3. 3.Division of Thoracic Oncology, Department of Chest MedicineTaipei Veterans General HospitalTaipeiTaiwan
  4. 4.Department of Pathology and Laboratory MedicineTaipei Veterans General HospitalTaipeiTaiwan

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