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Updated: Jun 1, 2026
Ultra-Fast Amplicon-Based Next-Generation Sequencing in Non-Squamous Non-Small Cell Lung Cancer
Published on: September 8, 2023
[Histology-based algorithm in the molecular diagnosis of mutations of the Epidernal Growth Factor Receptor (EGFR) in
Helmut Popper1, Fritz Wrba, Ulrike Gruber-Mösenbacher
1Institut für Pathologie, MedUni Graz, Graz, Austria. helmut.popper@medunigraz.at
Abstract:
Patients with stage IIIB and IV non-small cell lung carcinoma (NSCLC) harboring an activating mutation of the Epidermal Growth Factor Receptor (EGFR) Gene should be treated first-line with Gefitinib, an EGFR tyrosine kinase inhibitor (TKI). EGF receptor mutations are most common in adenocarcinomas, especially non-mucinous type, rare in squamous cell carcinomas and sarcomatoid carcinomas, and do not occur in neuroendocrine carcinomas. Therefore, the Pulmonary Pathology Working Group of the Austrian Society of Pathology, after intense discussions and in consensus with Oncologists and Pulmonologists, recommends a priori EGFR mutation analysis for all cases of adenocarcinoma, and for all other NSCLC upon clinical request. This will markedly reduce waiting time for those patients, which most likely will have the greatest benefit from EGFR TKI therapy.
Insights
Testing Epidermal Growth Factor Receptor (EGFR) mutation analysis in non-small cell lung carcinoma (NSCLC) patients is recommended. Early EGFR mutation testing ensures timely treatment with EGFR tyrosine kinase inhibitors (TKIs) for improved outcomes.
Area of Science:
- Oncology
- Pathology
- Genetics
Background:
- Advanced non-small cell lung carcinoma (NSCLC) patients with activating Epidermal Growth Factor Receptor (EGFR) mutations benefit from first-line Gefitinib therapy.
- EGFR mutations are prevalent in adenocarcinomas but rare in other NSCLC subtypes.
Framework:
- The Austrian Society of Pathology's Pulmonary Pathology Working Group developed consensus recommendations.
- Recommendations involve collaboration between pathologists, oncologists, and pulmonologists.
Implementation:
- EGFR mutation analysis is recommended a priori for all adenocarcinomas.
- Analysis is advised for other NSCLC types upon clinical request.
Implications:
- This strategy aims to reduce diagnostic waiting times for NSCLC patients.
- Timely EGFR mutation status determination facilitates prompt initiation of targeted EGFR tyrosine kinase inhibitor (TKI) therapy, maximizing patient benefit.
