Table of ContentsView AllTable of ContentsWhat It IsWho Is at Risk?SymptomsTreatmentSupport
Table of ContentsView All
View All
Table of Contents
What It Is
Who Is at Risk?
Symptoms
Treatment
Support
EGFR-positive lung cancer is a type of lung cancer with an epidermal growth factor receptor (EGFR) mutation. In the United States, around 10% to 15% of lung cancers are EGFR-positive.Most of these occur in adenocarcinoma non-small cell lung cancer.
Gene testing can identify an EGFR mutation, and advances in lung cancer treatment have made it possible to target these proteins to halt the growth of cancer cells. These drug treatments won’t cure your lung cancer, but they can help you manage the disease and stave off serious symptoms.
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What Is EGFR-Positive Lung Cancer?
Epidermal growth factor receptor (EGFR) is a protein present on the surface of both healthy cells and cancer cells. EGFR plays an important role in controlling cell division and survival. A mutation can cause EGFR to work incorrectly, causing rapid cell growth that helps the cancer spread.
The EGFR gene is divided into 28 numbered sections called exons, each of which are at risk for mutation. The most common EGFR mutations include missing genetic material on exon 19 (19-del) or damage to exon 21 (21-L858R). These two mutations account for about 85% of the EGFR mutations of lungcancer cells.Exon 20 insertion mutations may also occur, but they are much rarer.
According to research, certain ethnicities are more susceptible to EGFR mutations. People of Asian descent who developnon-small cell lung cancer (NSCLC)are almost 47% more likely to have the mutation. Among those of Middle-Eastern or African descent, the estimate is approximately 21%, while those of European heritage have a 12% chance.
There are several common factors related to the EGFR mutations. Those more likely to have the mutation are patients diagnosed with non-small cell lung cancer who are:
How the EGFR Mutation Is Identified
Lab tests can identify EGFR mutations in people who have beendiagnosed with lung cancer. All patients with advanced non-small cell lung cancer, especially those specifically diagnosed with adenocarcinoma, are evaluated for EGFR genetic mutations.
EGFR-Positive Lung Cancer Symptoms
You can’t tell if your cancer is EGFR-positive based on symptoms alone. Symptoms relate to the type of cancer you have rather than the fact that it is EGFR-positive. Because EGFR mutations are most often associated with lung adenocarcinomas, symptoms may not appear during theearly stagesof the disease.
Adenocarcinoma tumors appear on the outer areas of the lungs. Since they are not near the airways, breathing may not be affected until the cancer has progressed to anadvanced stage. Typicalearly symptomsof lung cancer such as fatigue, mild shortness of breath, or upper back and chest pain may not be present or might mistakenly be attributed to other causes.
When symptoms do finally appear, they are similar to the signs associated with other types of lung cancer, including:
What is the survival rate of EGFR-positive lung cancer?The life expectancy for someone with EGFR-positive lung cancer varies depending on things such as age at diagnosis, the stage of cancer, and overall health. However, new drugs can help improve survival times. For example, a recent study found that people who had EGFR cancer that spread to the brain and were treated with EGFR inhibitors had survival rates of 96% after one year and 74% after 2 years.
What is the survival rate of EGFR-positive lung cancer?
The life expectancy for someone with EGFR-positive lung cancer varies depending on things such as age at diagnosis, the stage of cancer, and overall health. However, new drugs can help improve survival times. For example, a recent study found that people who had EGFR cancer that spread to the brain and were treated with EGFR inhibitors had survival rates of 96% after one year and 74% after 2 years.
Diagnosis
Your healthcare provider may also be able to check for the mutations via a special blood test called a liquid biopsy, which analyzes DNA that has been shed from tumor cells in your blood.Often, the DNA sample from a blood draw is not significant enough to make a clear diagnosis, but research is being done to find effective ways to use liquid biopsies in the diagnosis or monitoring of lung cancer.
EGFR-Positive Lung Cancer Treatment
EGFR-positive lung cancer is usually treated with FDA-approvedtargeted therapy drugs.This is a change from how they were treated historically whenchemotherapywas the first course of treatment for almost all cases of advanced non-small cell lung cancer.
Lung cancer with EGFR mutations is often not diagnosed until the disease is atstage 3 or 4, so treatment doesn’t usually focus on curing the cancer; instead, it’s aimed at managing the spread and relieving symptoms.
Targeted therapy medications tend to have fewer side effects than chemotherapy and will not kill healthy cells. The introduction of targeted therapy medications over the past decade has given patients new opportunities to stop lung cancer from advancing while improvingsurvival ratesand quality of life.
The targeted therapy drugs Lazcluze (lazertinib), Tagrisso (osimertinib), Tarceva (erlotinib), Gilotrif (afatinib),and Iressa (gefitinib) are known as tyrosine kinase inhibitors. They prevent the EGFR protein on mutated cells from triggering tyrosine kinase, an enzyme within cells that activates cell division and, thus, multiplies cancer cells.Rybrevant (amivantamab) is a monoclonal antibody used alone or in combination with Lazcluze.
Tagrisso is now recommended as a first-line treatment for EGFR mutations because it’s best able to penetrate into the cerebrospinal fluid and pass through the blood-brain barrier to help fightlung cancer with brain metastases—particularly important because lung cancer often spreads to the brain.
To treat EGFR-positive squamous cell lung cancer, healthcare providers use a combination of chemotherapy and immunotherapy. And there are a growing number of therapies for patients with tumors who have specific types of genetic mutations, like exon abnormalities. Rybrevant (amivantamab-vmjw), for example, is approved for tumors with EGFR exon 20 insertion mutations. Traditional EGFR inhibitors are not as effective for this indication.
Clinical TrialsTremendous progress has been made in both the identification of genetic changes with lung cancer and targeted therapies to treat these changes. There are manyclinical trialslooking at other medications to treat EGFR mutation-positive lung cancer, as well as treatments for other molecular changes in cancer cells.
Clinical Trials
Tremendous progress has been made in both the identification of genetic changes with lung cancer and targeted therapies to treat these changes. There are manyclinical trialslooking at other medications to treat EGFR mutation-positive lung cancer, as well as treatments for other molecular changes in cancer cells.
Side Effects
The most common side effect of tyrosine kinase inhibitors is a skin rash. Less frequently, diarrhea may also occur.
Tarceva (erlotinib) skin rashes (and rashes from other tyrosine kinase inhibitors) resemble acne, occurring on the face, upper chest, and back. If no whiteheads are present, a topical corticosteroid cream—ahydrocortisonecream, for example—is used. If whiteheads are present and the rash looks infected, oral antibiotics are prescribed. In some cases, the tyrosine kinase inhibitor dose may be reduced.
Resistance to Treatment
Unfortunately, though lung cancers may respond very well to targeted therapy medications at first, they almost always become resistant over time.When this happens, healthcare providers look to other targeted therapy drugs or new approaches to treatment, which may include combining treatments.
The length of time it takes for targeted therapy resistance to develop varies, but nine to 13 months is common; although, for some people, medications can continue to be effective for many years.
If there are signs that the cancer is starting to grow again or spread, your healthcare provider will order a repeat biopsy and additional genetic testing to determine if there are further mutations or drug resistance.
Support and Coping
If you’ve recently been diagnosed with lung cancer, you’re doing one of the best things you can do right now—taking the time to learn about your cancer.
In addition to growing your understanding about your disease, learn how toadvocate for yourselfas a cancer patient.
The lung cancersupport communityis strong and getting stronger. Many people find it helpful to become involved in these support groups and communities not only as a way to find help from someone who has “been there” but as a method of staying abreast of the latest research on the disease.
Summary
EGFR-positive lung cancer is a type of lung cancer with a mutation in the epidermal growth factor receptor. This mutation causes the cancer to grow quickly.
The EGFR mutation is identified with lab tests. Targeted therapy drugs are usually the first line of treatment for these kinds of lung cancers.
16 Sources
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American Lung Association.EGFR info for patients.
National Cancer Institute.EGFR.
Hong W, Wu Q, Zhang J, Zhou Y.Prognostic value of EGFR 19-del and 21-L858R mutations in patients with non-small cell lung cancer.Oncol Lett. 2019;18(4):3887-3895. doi:0.3892%2Fol.2019.10715
Benbrahim Z, Antonia T, Mellas N.EGFR mutation frequency in Middle East and African non-small cell lung cancer patients: a systematic review and meta-analysis.BMC Cancer. 2018;18(1):891. doi:10.1186%2Fs12885-018-4774-y
American Cancer Society.Signs and symptoms of lung cancer.
Wang J, Liu Z, Pang Q, et al.Prognostic analysis of patients with non-small cell lung cancer harboring exon 19 or 21 mutation in the epidermal growth factor gene and brain metastases.BMC Cancer. 2020;20(1):837. doi:10.1186/s12885-020-07249-7
U.S. Food and Drug Administration.Cobas EGFR mutation test v2.
Grosse A, Grosse C, Rechsteiner M, Soltermann A.Analysis of the frequency of oncogenic driver mutations and correlation with clinicopathological characteristics in patients with lung adenocarcinoma from Northeastern Switzerland.Diagn Pathol.2019;14(1):18. doi:10.1186/s13000-019-0789-1
Yuan M, Huang LL, Chen JH, Wu J, Xu Q.The emerging treatment landscape of targeted therapy in non-small-cell lung cancer.Signal Transduct Target Ther. 2019;4:61. doi:10.1038/s41392-019-0099-9
Zappa C, Mousa SA.Non-small cell lung cancer: current treatment and future advances.Transl Lung Cancer Res. 2016;5(3):288-300. doi:10.21037/tlcr.2016.06.07
Reddi HV.Mutations in the EGFR pathway. American Association for Clinical Chemistry.
Liam CK.Central nervous system activity of first-line osimertinib in epidermal growth factor receptor-mutant advanced non-small cell lung cancer.Ann Transl Med.2019;7(3):61. doi:10.21037/atm.2018.12.68
Kozuki T.Skin problems and EGFR-tyrosine kinase inhibitor.Jpn J Clin Oncol.2016;46(4):291-8. doi:10.1093/jjco/hyv207
Passaro A, Di Maio M, Del Signore E, Gori B, De Marinis F.Management of nonhematologic toxicities associated with different EGFR-TKIs in advanced NSCLC: a comparison analysis.Clin Lung Cancer.2014;15(4):307-12. doi:10.1016/j.cllc.2014.04.006
Gainor JF, Shaw AT.Emerging paradigms in the development of resistance to tyrosine kinase inhibitors in lung cancer.J Clin Oncol.2013;31(31):3987-96. doi:10.1200/JCO.2012.45.2029
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