Consensus for EGFR mutation testing in non-small cell lung cancer: Results from a European workshop

Robert Pirker, Felix J F Herth, Keith M. Kerr, Martin Filipits, Miquel Taron, David R Gandara, Fred R. Hirsch, Dominique Grunenwald, Helmut Popper, Egbert Smit, Manfred Dietel, Antonio Marchetti, Christian Manegold, Peter Schirmacher, Michael Thomas, Rafael Rosell, Federico Cappuzzo, Rolf Stahel

Research output: Contribution to journalArticle

233 Citations (Scopus)

Abstract

Introduction: Activating somatic mutations of the tyrosine kinase domain of epidermal growth factor receptor (EGFR) have recently been characterized in a subset of patients with advanced non-small cell lung cancer (NSCLC). Patients harboring these mutations in their tumors show excellent response to EGFR tyrosine kinase inhibitors (EGFR-TKIs). The EGFR-TKI gefitinib has been approved in Europe for the treatment of adult patients with locally advanced or metastatic NSCLC with activating mutations of the EGFR TK. Because EGFR mutation testing is not yet well established across Europe, biomarker-directed therapy only slowly emerges for the subset of NSCLC patients most likely to benefit: those with EGFR mutations. Methods: The "EGFR testing in NSCLC: from biology to clinical practice" International Association for the Study of Lung Cancer-European Thoracic Oncology Platform multidisciplinary workshop aimed at facilitating the implementation of EGFR mutation testing. Recommendations for high-quality EGFR mutation testing were formulated based on the opinion of the workshop expert group. Results: Co-operation and communication flow between the various disciplines was considered to be of most importance. Participants agreed that the decision to request EGFR mutation testing should be made by the treating physician, and results should be available within 7 working days. There was agreement on the importance of appropriate sampling techniques and the necessity for the standardization of tumor specimen handling including fixation. Although there was no consensus on which laboratory test should be preferred for clinical decision making, all stressed the importance of standardization and validation of these tests. Conclusion: The recommendations of the workshop will help implement EGFR mutation testing in Europe and, thereby, optimize the use of EGFR-TKIs in clinical practice.

Original languageEnglish (US)
Pages (from-to)1706-1713
Number of pages8
JournalJournal of Thoracic Oncology
Volume5
Issue number10
DOIs
StatePublished - Oct 2010

Fingerprint

Epidermal Growth Factor Receptor
Non-Small Cell Lung Carcinoma
Consensus
Education
Mutation
Protein-Tyrosine Kinases
Specimen Handling
Expert Testimony
Neoplasms
Thorax
Biomarkers
Communication
Physicians

Keywords

  • EGFR mutation
  • EGFR testing recommendations
  • Epidermal growth factor receptor
  • Erlotinib
  • Gefitinib
  • Non-small cell lung cancer
  • Tyrosine kinase inhibitors

ASJC Scopus subject areas

  • Oncology
  • Pulmonary and Respiratory Medicine

Cite this

Consensus for EGFR mutation testing in non-small cell lung cancer : Results from a European workshop. / Pirker, Robert; Herth, Felix J F; Kerr, Keith M.; Filipits, Martin; Taron, Miquel; Gandara, David R; Hirsch, Fred R.; Grunenwald, Dominique; Popper, Helmut; Smit, Egbert; Dietel, Manfred; Marchetti, Antonio; Manegold, Christian; Schirmacher, Peter; Thomas, Michael; Rosell, Rafael; Cappuzzo, Federico; Stahel, Rolf.

In: Journal of Thoracic Oncology, Vol. 5, No. 10, 10.2010, p. 1706-1713.

Research output: Contribution to journalArticle

Pirker, R, Herth, FJF, Kerr, KM, Filipits, M, Taron, M, Gandara, DR, Hirsch, FR, Grunenwald, D, Popper, H, Smit, E, Dietel, M, Marchetti, A, Manegold, C, Schirmacher, P, Thomas, M, Rosell, R, Cappuzzo, F & Stahel, R 2010, 'Consensus for EGFR mutation testing in non-small cell lung cancer: Results from a European workshop', Journal of Thoracic Oncology, vol. 5, no. 10, pp. 1706-1713. https://doi.org/10.1097/JTO.0b013e3181f1c8de
Pirker, Robert ; Herth, Felix J F ; Kerr, Keith M. ; Filipits, Martin ; Taron, Miquel ; Gandara, David R ; Hirsch, Fred R. ; Grunenwald, Dominique ; Popper, Helmut ; Smit, Egbert ; Dietel, Manfred ; Marchetti, Antonio ; Manegold, Christian ; Schirmacher, Peter ; Thomas, Michael ; Rosell, Rafael ; Cappuzzo, Federico ; Stahel, Rolf. / Consensus for EGFR mutation testing in non-small cell lung cancer : Results from a European workshop. In: Journal of Thoracic Oncology. 2010 ; Vol. 5, No. 10. pp. 1706-1713.
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abstract = "Introduction: Activating somatic mutations of the tyrosine kinase domain of epidermal growth factor receptor (EGFR) have recently been characterized in a subset of patients with advanced non-small cell lung cancer (NSCLC). Patients harboring these mutations in their tumors show excellent response to EGFR tyrosine kinase inhibitors (EGFR-TKIs). The EGFR-TKI gefitinib has been approved in Europe for the treatment of adult patients with locally advanced or metastatic NSCLC with activating mutations of the EGFR TK. Because EGFR mutation testing is not yet well established across Europe, biomarker-directed therapy only slowly emerges for the subset of NSCLC patients most likely to benefit: those with EGFR mutations. Methods: The {"}EGFR testing in NSCLC: from biology to clinical practice{"} International Association for the Study of Lung Cancer-European Thoracic Oncology Platform multidisciplinary workshop aimed at facilitating the implementation of EGFR mutation testing. Recommendations for high-quality EGFR mutation testing were formulated based on the opinion of the workshop expert group. Results: Co-operation and communication flow between the various disciplines was considered to be of most importance. Participants agreed that the decision to request EGFR mutation testing should be made by the treating physician, and results should be available within 7 working days. There was agreement on the importance of appropriate sampling techniques and the necessity for the standardization of tumor specimen handling including fixation. Although there was no consensus on which laboratory test should be preferred for clinical decision making, all stressed the importance of standardization and validation of these tests. Conclusion: The recommendations of the workshop will help implement EGFR mutation testing in Europe and, thereby, optimize the use of EGFR-TKIs in clinical practice.",
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AU - Hirsch, Fred R.

AU - Grunenwald, Dominique

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AU - Dietel, Manfred

AU - Marchetti, Antonio

AU - Manegold, Christian

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N2 - Introduction: Activating somatic mutations of the tyrosine kinase domain of epidermal growth factor receptor (EGFR) have recently been characterized in a subset of patients with advanced non-small cell lung cancer (NSCLC). Patients harboring these mutations in their tumors show excellent response to EGFR tyrosine kinase inhibitors (EGFR-TKIs). The EGFR-TKI gefitinib has been approved in Europe for the treatment of adult patients with locally advanced or metastatic NSCLC with activating mutations of the EGFR TK. Because EGFR mutation testing is not yet well established across Europe, biomarker-directed therapy only slowly emerges for the subset of NSCLC patients most likely to benefit: those with EGFR mutations. Methods: The "EGFR testing in NSCLC: from biology to clinical practice" International Association for the Study of Lung Cancer-European Thoracic Oncology Platform multidisciplinary workshop aimed at facilitating the implementation of EGFR mutation testing. Recommendations for high-quality EGFR mutation testing were formulated based on the opinion of the workshop expert group. Results: Co-operation and communication flow between the various disciplines was considered to be of most importance. Participants agreed that the decision to request EGFR mutation testing should be made by the treating physician, and results should be available within 7 working days. There was agreement on the importance of appropriate sampling techniques and the necessity for the standardization of tumor specimen handling including fixation. Although there was no consensus on which laboratory test should be preferred for clinical decision making, all stressed the importance of standardization and validation of these tests. Conclusion: The recommendations of the workshop will help implement EGFR mutation testing in Europe and, thereby, optimize the use of EGFR-TKIs in clinical practice.

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