Skip to main content
Top
Published in: Journal of Cancer Research and Clinical Oncology 1/2015

Open Access 01-01-2015 | Original Article – Cancer Research

The efficacy of EGFR gene mutation testing in various samples from non-small cell lung cancer patients: a multicenter retrospective study

Authors: Paweł Krawczyk, Rodryg Ramlau, Joanna Chorostowska-Wynimko, Tomasz Powrózek, Marzena Anna Lewandowska, Janusz Limon, Bartosz Wasąg, Juliusz Pankowski, Jerzy Kozielski, Ewa Kalinka-Warzocha, Aleksandra Szczęsna, Kamila Wojas-Krawczyk, Michał Skroński, Rafał Dziadziuszko, Paulina Jaguś, Ewelina Antoszewska, Justyna Szumiło, Bożena Jarosz, Aldona Woźniak, Wojciech Jóźwicki, Wojciech Dyszkiewicz, Monika Pasieka-Lis, Dariusz M. Kowalski, Maciej Krzakowski, Jacek Jassem, Janusz Milanowski

Published in: Journal of Cancer Research and Clinical Oncology | Issue 1/2015

Login to get access

Abstract

Introduction

Testing for the epidermal growth factor receptor (EGFR) gene mutations requires considerable multidisciplinary experience of clinicians (for appropriate patient selection), pathologists (for selection of appropriate cytological or histological material) and geneticists (for performing and reporting reliable molecular tests). We present our experience on the efficacy of routine EGFR testing in various types of tumor samples and the frequency of EGFR mutations in a large series of Polish non-small cell lung cancer (NSCLC) patients.

Methods

Deletions in exon 19 and substitution L858R in exon 21 of EGFR gene were assessed using real-time PCR techniques in 1,138 small biopsies or cytological specimens and in 1,312 surgical samples.

Results

Out of 2,450 diagnostic samples (containing >10 % of tumor cells), the occurrence of EGFR gene mutations was 9 %; more frequently in women (13.9 %) and adenocarcinoma patients (10 %), particularly with accompanying expression of TTF1 (13.0 %). The frequency of EGFR gene mutations was similar in cytological and histological specimens, and in primary and metastatic lesions, and did not depend on the percentage of tumor cells and quality of isolated DNA. Cytological or small biopsy, compared to surgical specimens showed lower percentage of tumor cells, with no impact on the quality of real-time PCR assay.

Conclusion

Cytological and small biopsy samples with low (10–20 %) content of tumor cells and specimens from metastatic lesions are a sufficient source for EGFR mutation testing in NSCLC patients. The incidence of EGFR gene mutations in examined population was similar to those reported in other Caucasian populations.
Literature
go back to reference Aisner DL, Marshall CB (2012) Molecular pathology of non-small cell lung cancer: a practical guide. Am J Clin Pathol 138:332–346PubMedCrossRef Aisner DL, Marshall CB (2012) Molecular pathology of non-small cell lung cancer: a practical guide. Am J Clin Pathol 138:332–346PubMedCrossRef
go back to reference Allegrini S, Antona J, Mezzapelle R et al (2012) Epidermal growth factor receptor gene analysis with a highly sensitive molecular assay in routine cytologic specimens of lung adenocarcinoma. Am J Clin Pathol 138:377–381PubMedCrossRef Allegrini S, Antona J, Mezzapelle R et al (2012) Epidermal growth factor receptor gene analysis with a highly sensitive molecular assay in routine cytologic specimens of lung adenocarcinoma. Am J Clin Pathol 138:377–381PubMedCrossRef
go back to reference Billah S, Stewart J, Staerkel G et al (2011) EGFR and KRAS mutations in lung carcinoma: molecular testing by using cytology specimens. Cancer Cytopathol 119:111–117PubMedCrossRef Billah S, Stewart J, Staerkel G et al (2011) EGFR and KRAS mutations in lung carcinoma: molecular testing by using cytology specimens. Cancer Cytopathol 119:111–117PubMedCrossRef
go back to reference Boch C, Kollmeier J, Roth A et al (2013) The frequency of EGFR and KRAS mutations in non-small cell lung cancer (NSCLC): routine screening data for central Europe from a cohort study. BMJ Open 3:e002560PubMedCentralPubMedCrossRef Boch C, Kollmeier J, Roth A et al (2013) The frequency of EGFR and KRAS mutations in non-small cell lung cancer (NSCLC): routine screening data for central Europe from a cohort study. BMJ Open 3:e002560PubMedCentralPubMedCrossRef
go back to reference Eberhard DA, Giaccone G, Johnson BE et al (2008) Biomarkers of response to epidermal growth factor receptor inhibitors in Non-Small-Cell Lung Cancer Working Group: standardization for use in the clinical trial setting. J Clin Oncol 26:983–994PubMedCrossRef Eberhard DA, Giaccone G, Johnson BE et al (2008) Biomarkers of response to epidermal growth factor receptor inhibitors in Non-Small-Cell Lung Cancer Working Group: standardization for use in the clinical trial setting. J Clin Oncol 26:983–994PubMedCrossRef
go back to reference Esterbrook G, Anathhanam S, Plant PK (2013) Adequacy of endobronchial ultrasound transbronchial needle aspiration samples in the subtyping of non-small cell lung cancer. Lung Cancer 80:30–34PubMedCrossRef Esterbrook G, Anathhanam S, Plant PK (2013) Adequacy of endobronchial ultrasound transbronchial needle aspiration samples in the subtyping of non-small cell lung cancer. Lung Cancer 80:30–34PubMedCrossRef
go back to reference Gahr S, Stoehr R, Geissinger E et al (2013) EGFR mutational status in a large series of Caucasian European NSCLC patients: data from daily practice. Br J Cancer 109:1281–1288CrossRef Gahr S, Stoehr R, Geissinger E et al (2013) EGFR mutational status in a large series of Caucasian European NSCLC patients: data from daily practice. Br J Cancer 109:1281–1288CrossRef
go back to reference Hiramatsu M, Ninomiya H, Inamura K et al (2010) Activation status of receptor tyrosine kinase downstream pathways in primary lung adenocarcinoma with reference of KRAS and EGFR mutations. Lung Cancer 70:94–102PubMedCrossRef Hiramatsu M, Ninomiya H, Inamura K et al (2010) Activation status of receptor tyrosine kinase downstream pathways in primary lung adenocarcinoma with reference of KRAS and EGFR mutations. Lung Cancer 70:94–102PubMedCrossRef
go back to reference Khode R, Larsen DA, Culbreath BC et al (2013) Comparative study of epidermal growth factor receptor mutation analysis on cytology smears and surgical pathology specimens from primary and metastatic lung carcinomas. Cancer Cytopathol 121:361–369PubMedCrossRef Khode R, Larsen DA, Culbreath BC et al (2013) Comparative study of epidermal growth factor receptor mutation analysis on cytology smears and surgical pathology specimens from primary and metastatic lung carcinomas. Cancer Cytopathol 121:361–369PubMedCrossRef
go back to reference Krawczyk P, Ramlau R, Powrózek T et al (2012) The detection of EGFR mutations in patients with non-small cell lung cancer in selected molecular diagnostics centers in Poland. Kardiochir Torakochir Pol 9:431–438 Krawczyk P, Ramlau R, Powrózek T et al (2012) The detection of EGFR mutations in patients with non-small cell lung cancer in selected molecular diagnostics centers in Poland. Kardiochir Torakochir Pol 9:431–438
go back to reference Leary AF, Castro DG, Nicholson AG et al (2012) Establishing an EGFR mutation screening service for non-small cell lung cancer—sample quality criteria and candidate histological predictors. Eur J Cancer 48:61–67PubMedCrossRef Leary AF, Castro DG, Nicholson AG et al (2012) Establishing an EGFR mutation screening service for non-small cell lung cancer—sample quality criteria and candidate histological predictors. Eur J Cancer 48:61–67PubMedCrossRef
go back to reference Lee CK, Brown C, Grala RJ et al (2013) Impact of EGFR inhibitor in non-small cell lung cancer on progression-free and overall survival: a meta-analysis. J Natl Cancer Inst 105:595–605PubMedCrossRef Lee CK, Brown C, Grala RJ et al (2013) Impact of EGFR inhibitor in non-small cell lung cancer on progression-free and overall survival: a meta-analysis. J Natl Cancer Inst 105:595–605PubMedCrossRef
go back to reference Ma ES, Ng WK, Wong CL (2012) EGFR gene mutation study in cytology specimens. Acta Cytol 56:661–668PubMedCrossRef Ma ES, Ng WK, Wong CL (2012) EGFR gene mutation study in cytology specimens. Acta Cytol 56:661–668PubMedCrossRef
go back to reference Petrelli F, Borgonovo K, Cabiddu M et al (2012) Efficacy of EGFR tyrosine kinase inhibitors in patients with EGFR-mutated non-small cell lung cancer: a meta-analysis of 13 randomised trials. Clin Lung Cancer 13:107–114PubMedCrossRef Petrelli F, Borgonovo K, Cabiddu M et al (2012) Efficacy of EGFR tyrosine kinase inhibitors in patients with EGFR-mutated non-small cell lung cancer: a meta-analysis of 13 randomised trials. Clin Lung Cancer 13:107–114PubMedCrossRef
go back to reference Rosell R, Moran T, Queralt C et al (2009) Screening for epidermal growth factor receptor mutations in lung cancer. N Engl J Med 361:958–967PubMedCrossRef Rosell R, Moran T, Queralt C et al (2009) Screening for epidermal growth factor receptor mutations in lung cancer. N Engl J Med 361:958–967PubMedCrossRef
go back to reference Rosell R, Carcereny E, Gervais R et al (2012) 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 13:239–246PubMedCrossRef Rosell R, Carcereny E, Gervais R et al (2012) 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 13:239–246PubMedCrossRef
go back to reference Smouse JH, Cibas ES, Janne PA et al (2009) EGFR mutations are detected comparably in cytologic and surgical pathology specimens of nonsmall cell lung cancer. Cancer Cytopathol 117:67–72CrossRef Smouse JH, Cibas ES, Janne PA et al (2009) EGFR mutations are detected comparably in cytologic and surgical pathology specimens of nonsmall cell lung cancer. Cancer Cytopathol 117:67–72CrossRef
go back to reference Stella GM, Scabini R, Inghilleri S et al (2013) EGFR and KRAS mutational profiling in fresh non-small cell lung cancer (NSCLC) cells. J Cancer Res Clin Oncol 139:1327–1335PubMedCrossRef Stella GM, Scabini R, Inghilleri S et al (2013) EGFR and KRAS mutational profiling in fresh non-small cell lung cancer (NSCLC) cells. J Cancer Res Clin Oncol 139:1327–1335PubMedCrossRef
go back to reference Sun L, Zhang Q, Luan H et al (2011) Comparison of KRAS and EGFR gene status between primary non-small cell lung cancer and local lymph node metastases: implications for clinical practice. J Exp Clin Cancer Res 30:30–38PubMedCentralPubMedCrossRef Sun L, Zhang Q, Luan H et al (2011) Comparison of KRAS and EGFR gene status between primary non-small cell lung cancer and local lymph node metastases: implications for clinical practice. J Exp Clin Cancer Res 30:30–38PubMedCentralPubMedCrossRef
go back to reference Sun PL, Jin Y, Kim H et al (2013) High concordance of EGFR mutation status between histologic and corresponding cytologic specimens of lung adenocarcinomas. Cancer Cytopathol 121:311–319PubMedCrossRef Sun PL, Jin Y, Kim H et al (2013) High concordance of EGFR mutation status between histologic and corresponding cytologic specimens of lung adenocarcinomas. Cancer Cytopathol 121:311–319PubMedCrossRef
go back to reference Tapia C, Savic S, Bihl M et al (2009) EGFR mutation analysis in non-small-cell lung cancer: experience from routine diagnostics. Pathologe 30:384–392PubMedCrossRef Tapia C, Savic S, Bihl M et al (2009) EGFR mutation analysis in non-small-cell lung cancer: experience from routine diagnostics. Pathologe 30:384–392PubMedCrossRef
go back to reference Togashi Y, Masago K, Kubo T et al (2011) Association of diffuse, random pulmonary metastases, including milliary metastases, with epidermal growth factor receptor mutations in lung adenocarcinoma. Cancer 117:819–825PubMedCrossRef Togashi Y, Masago K, Kubo T et al (2011) Association of diffuse, random pulmonary metastases, including milliary metastases, with epidermal growth factor receptor mutations in lung adenocarcinoma. Cancer 117:819–825PubMedCrossRef
go back to reference Travis WD, Brambilla E, Noguchi M et al (2011) International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society International Multidisciplinary Classification of Lung Adenocarcinoma. J Thorac Oncol 6:244–285PubMedCrossRef Travis WD, Brambilla E, Noguchi M et al (2011) International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society International Multidisciplinary Classification of Lung Adenocarcinoma. J Thorac Oncol 6:244–285PubMedCrossRef
go back to reference Wojas-Krawczyk K, Skroński M, Krawczyk P et al (2013) EGFR activating mutations detected by different PCR techniques in Caucasian NSCLC patients with CNS metastases: short report. Clin Exp Metastasis. doi:10.1007/s10585-013-9603-8 Wojas-Krawczyk K, Skroński M, Krawczyk P et al (2013) EGFR activating mutations detected by different PCR techniques in Caucasian NSCLC patients with CNS metastases: short report. Clin Exp Metastasis. doi:10.​1007/​s10585-013-9603-8
Metadata
Title
The efficacy of EGFR gene mutation testing in various samples from non-small cell lung cancer patients: a multicenter retrospective study
Authors
Paweł Krawczyk
Rodryg Ramlau
Joanna Chorostowska-Wynimko
Tomasz Powrózek
Marzena Anna Lewandowska
Janusz Limon
Bartosz Wasąg
Juliusz Pankowski
Jerzy Kozielski
Ewa Kalinka-Warzocha
Aleksandra Szczęsna
Kamila Wojas-Krawczyk
Michał Skroński
Rafał Dziadziuszko
Paulina Jaguś
Ewelina Antoszewska
Justyna Szumiło
Bożena Jarosz
Aldona Woźniak
Wojciech Jóźwicki
Wojciech Dyszkiewicz
Monika Pasieka-Lis
Dariusz M. Kowalski
Maciej Krzakowski
Jacek Jassem
Janusz Milanowski
Publication date
01-01-2015
Publisher
Springer Berlin Heidelberg
Published in
Journal of Cancer Research and Clinical Oncology / Issue 1/2015
Print ISSN: 0171-5216
Electronic ISSN: 1432-1335
DOI
https://doi.org/10.1007/s00432-014-1789-x

Other articles of this Issue 1/2015

Journal of Cancer Research and Clinical Oncology 1/2015 Go to the issue
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.