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Related Experiment Video

Updated: Jul 6, 2026

Visualizing Genetic Variants, Short Targets, and Point Mutations in the Morphological Tissue Context with an RNA In Situ Hybridization Assay
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Visualizing Genetic Variants, Short Targets, and Point Mutations in the Morphological Tissue Context with an RNA In Situ Hybridization Assay

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EGFR FISH versus mutation: different tests, different end-points.

Federico Cappuzzo1

  • 1Istituto Clinico Humanitas IRCCS, Division of Oncology-Hematology, via Manzoni 56, 20089 Rozzano, Italy. federico.cappuzzo@humanitas.it

Lung Cancer (Amsterdam, Netherlands)
|March 28, 2008
PubMed
Summary
This summary is machine-generated.

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For non-small cell lung cancer (NSCLC), fluorescence in situ hybridization (FISH) for EGFR gene copy number is superior to mutation analysis for selecting patients who benefit from EGFR-TKIs. FISH improves survival outcomes in NSCLC patients treated with targeted therapy.

Area of Science:

  • Oncology
  • Molecular Biology
  • Genetics

Background:

  • Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) improve survival in non-small cell lung cancer (NSCLC) patients post-chemotherapy.
  • Patient selection for EGFR-TKIs can be guided by clinical features like smoking history, but molecular assessment is crucial.
  • EGFR mutations and gene copy number (via FISH) identify NSCLC patients likely to respond to EGFR-TKIs.

Purpose of the Study:

  • To evaluate the optimal method for patient selection for EGFR-TKI therapy in NSCLC.
  • To determine whether EGFR mutation analysis or FISH is superior for predicting survival benefits.

Main Methods:

  • Review of data from large randomized clinical trials involving EGFR-TKIs in NSCLC.
  • Analysis of patient selection biomarkers, including EGFR mutations and EGFR gene copy number assessed by FISH.

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Visualizing Genetic Variants, Short Targets, and Point Mutations in the Morphological Tissue Context with an RNA In Situ Hybridization Assay
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Published on: August 14, 2018

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Detection of Rare Mutations in CtDNA Using Next Generation Sequencing

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  • Comparison of survival outcomes based on different patient stratification methods.

    • Main Results:

    • Survival improvement with EGFR-TKIs is observed in patients with stable or progressive disease, not just tumor shrinkage.
    • FISH assessment of EGFR gene copy number was the only EGFR test significantly associated with prolonged survival in large randomized trials.
    • FISH is identified as the most reliable method for patient selection when survival is the primary endpoint.

    Conclusions:

    • Fluorescence in situ hybridization (FISH) is the preferred method for selecting non-small cell lung cancer patients for EGFR-TKI therapy when survival is the main objective.
    • While EGFR mutations are indicative of response, FISH provides a stronger correlation with overall survival benefits.
    • Clinical and biological predictors of TKI sensitivity should be considered in trial design, as patients with these markers may benefit from standard chemotherapy.