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An estimated 222,500 new cases of lung cancer were diagnosed in the US in 2017.1 The 2 main types of lung cancer are:
This website focuses on NSCLC, since it is the most common form of lung cancer.
The NSCLC treatment landscape is changing, and physicians are using biomarkers to help tailor and personalize therapy for their patients. Cancer biomarkers are substances in the body that can be identified or measured, and may be used to guide treatment decisions as well as predict how well a patient will respond to treatment.3 Some of the most common biomarkers in NSCLC are genetic changes, and include4,5:
NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) recommend testing for all actionable biomarkers at diagnosis of NSCLC, including EGFR, BRAF, ROS1 mutations, ALK rearrangements, and PD-L1 expression.5
Testing for EGFR mutations, which are present in a significant number of patients with NSCLC, is the focus of this website.
EGFR can be found on the surface of both healthy cells and lung cancer cells.6
EGFR Function in Healthy Cells6
In some patients with metastatic NSCLC, mutations or changes in the DNA code of EGFR may help cancer cells grow.6
ALK, anaplastic lymphoma kinase; BRAF, v-Raf murine sarcoma viral oncogene homolog B; PD-L1, programmed death-ligand 1; ROS1, ROS proto-oncogene 1, receptor tyrosine kinase.
Some types of EGFR mutations that help cancer cells grow and survive are considered sensitizing mutations.6,7
The most common EGFR sensitizing mutations are exon 19 deletions (in which a portion of the gene is missing) and the L858R point mutation (in which a specific part of the gene is changed).14
Exon 19 Deletions
L858R Point Mutation
Mutant EGFR in Cancer Cells6
Identifying EGFR mutations at diagnosis has implications for making treatment decisions. Testing for biomarkers, including EGFR mutations, is recommended by a number of national clinical organizations, including:
It is important to obtain results for all actionable biomarkers, including EGFR, before making treatment decisions.
The National Comprehensive Cancer Network makes no warranties of any kind whatsoever regarding their content, use or application and disclaims any responsibility for their application or use in any way.References: 1. American Cancer Society. What is non-small cell lung cancer? http://www.cancer.org/cancer/lungcancer-non-smallcell/detailedguide/non-small-cell-lung-cancer-what-is-non-small-cell-lung-cancer. Accessed August 1, 2018. 2. Molina JR, Yang P, Cassivi SD, Schild SE, Adjei AA. Non-small cell lung cancer: epidemiology, risk factors, treatment, and survivorship. Mayo Clin Proc. 2008;83(5):584-594. 3. Strimbu K, Tavel JA. What are biomarkers? Curr Opin HIV AIDS. 2010;5(6):463-466. doi:10.1097/COH.0b013e32833ed177. 4. Sholl LM, Aisner DL, Varella-Garcia M, et al. Multi-institutional oncogenic driver mutation analysis in lung adenocarcinoma: the lung cancer mutation consortium experience. J Thorac Oncol. 2015;10(5):768-777. doi:10.1097/JTO.0000000000000516. 5. Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Non-Small Cell Lung Cancer V3.2018. © National Comprehensive Cancer Network, Inc. 2018. All rights reserved. Accessed March 14, 2018. To view the most recent and complete version of the guideline, go online to NCCN.org.