EGFR-mutatie bij niet-kleincellig longcarcinoom

Conflict of interest: Via his institution Dr. E. Thunnissen received reimbursement from Astra Zeneca for attending a congress. Financial support: none declared.

• Non-small cell lung carcinomas (NSCLCs) in which there is a mutation of the epidermal growth factor receptor (EGFR) constitute a separate group of lung carcinomas. They occur more often in women, non-smokers and Asian people, take the form of adenocarcinoma and their prognosis is better.

• For a number of years, oral tyrosine kinase inhibitors (TKI’s) have been registered for the treatment of lung cancer. Response to therapy is high in lung carcinomas with an activating EGFR mutation, i.e. the signal transduction route is extra activated.

• In activating EGFR mutations, first-line treatment with EGFR-TKI is indicated.

• There are several techniques of detecting mutations including sequence analysis, high resolution melting (HRM) with sequence analysis and DXS gene scan. All these methods are based on PCR.

• Due to the importance of the results of the EGFR mutation analysis, we recommend that with the exception of squamous cell carcinoma, carcinoid and mucinous bronchiolo-alveolar cell carcinoma, all patients with incurable NSCLC should have EGFR mutation analysis.