Fast Five Quiz: Non–Small Cell Lung Cancer (NSCLC) and the Epidermal Growth Factor Receptor Gene (EGFR)

Daniel S. Schwartz, MD, MBA


November 30, 2021

All patients with advanced NSCLC adenocarcinomas should receive testing for activating EGFR mutations in exons 18-21 to help determine treatment selection. If T790M is identified without prior EGFR tyrosine kinase inhibitor (TKI) therapy, genetic counseling and germline genetic testing are indicated.

The probability of a mutation is dependent on the histologic subtype of the cancer. Therefore, histologic testing should precede mutation testing.

DNA mutational analysis is the preferred method to assess for EGFR status. FISH testing is used to detect ROS1, ALK, and NTRK gene fusions, as well as RET rearrangements.

Smoking status, ethnicity, and histology should not be used to guide selection of patients as candidates for EGFR mutation testing.

Learn more about the workup of patients with NSCLC.


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