EGFR-positive lung cancer is a type of non-small cell lung cancer (NSCLC). It can cause symptoms such as breathing problems and hoarseness. Therapy that targets the mutation, such as EGFR inhibitors, may help.
“EGFR” stands for “epidermal growth factor receptor.”
The EGFR gene controls the production of EGFR proteins, which are found in both healthy and abnormal cells. They help cells grow and divide.
When cancer cells test positive for the EGFR protein, it means that the EGFR gene contains a mutation and is sending faulty instructions to the cells. This mutation allows cancer to grow and spread.
Read on to learn more about EGFR-positive lung cancer, including the types of EGFR mutations and lung cancer, symptoms, risk factors, treatments, and more.
A mutation is an error in a specific part of the DNA. This type of error makes cells behave abnormally.
Certain errors cause cells to grow and divide at an unusually high rate, leading to cancer.
The most common EGFR mutations in people with lung cancer are the EGFR exon 19 deletion mutation and EGFR exon 21 L858R point mutation. They respond to targeted therapies called EGFR inhibitors.
Less common EGFR mutations, such as the EGFR exon 20 insertion mutation and EGFR exon T790M mutation, don’t usually respond to EGFR inhibitors.
EGFR-positive lung cancer is a subtype of NSCLC. NCSLCs account for
Different types of NSCLC can be EGFR positive.
There are three main subtypes of NSCLC:
- Adenocarcinoma: Adenocarcinoma forms in the outer area of the lung. Most lung cancers are adenocarcinomas, and it is the most common type of EGFR-positive lung cancer.
- Squamous cell carcinoma: Squamous cell carcinoma usually forms near bronchi, or the airways. Although less common, squamous cell carcinoma can also be EGFR positive.
- Large cell carcinoma: Large cell carcinoma can start anywhere in the lungs. In general, large cell carcinoma tends to spread faster than adenocarcinoma or squamous cell carcinoma. It can also be EGFR positive.
Learn more about types of NSCLC.
Symptoms of EGFR-positive lung cancer are the same as those of other types of lung cancer.
You
- hoarseness
- chest pain
- shortness of breath
- wheezing
- a cough
- coughing up blood
- frequent bronchitis, pneumonia, or other lung infections
As the cancer spreads, symptoms can include:
Learn more about early signs of lung cancer.
In general, risk factors for lung cancer
- smoking
- genetics
- exposure to air pollution
- occupational exposures, such as to asbestos, metals, and diesel fumes
People with EGFR mutations are more likely to be assigned female at birth and have never smoked or are light smokers.
When you’re evaluated for lung cancer, your appointment will likely start with a physical exam and a review of your medical history.
A healthcare professional may order imaging tests,
A lung cancer diagnosis can be confirmed with a biopsy. Doctors also use biopsies to test cancers for specific gene mutations. It’s now a routine part of diagnosing and staging lung cancer.
There are several ways to get the necessary tissue sample, including:
- needle aspiration
- bronchoscopy
- lung surgery
In 2016, the
Treatment for lung cancer depends on its stage and type.
When cancer is at a later stage, the goal of treatment is to slow disease progression and improve quality of life.
The initial treatment for advanced EGFR-positive lung cancer is likely surgery in the early stages, or targeted therapy in the later stages.
Chemotherapy and immunotherapy may also be options.
EGFR exon 19 deletion mutation
EGFR inhibitors are targeted therapies that work by blocking the activity of the EGFR protein.
EGFR inhibitors your doctor may recommend for the EGFR exon 19 deletion mutation
- dacomitinib (Vizimpro)
- erlotinib (Tarceva)
- gefitinib (Iressa)
- osimertinib (Tagrisso)
These medications are all administered orally.
EGFR exon 20 insertion mutation
The first-line treatment for the exon 20 insertion mutation is amivantamab (Rybrevant).
Doctors may also recommend mobocertinib (Exkivity).
Both are usually for people who’ve already tried chemotherapy.
Unlike other targeted therapies for EGFR-positive lung cancer, amivantamab-vmjw (Rybrevant) is an antibody treatment and not an EGFR inhibitor. It’s also administered by intravenous (IV) infusion instead of orally.
EGFR exon 21 L858R point mutation
Treatments for the exon 21 L858R point mutation can include:
- dacomitinib (Vizimpro)
- erlotinib (Tarceva)
- gefitinib (Iressa)
- osimertinib (Tagrisso)
These are the same medications used to treat NSCLCs with the EGFR exon 19 deletion mutation.
EGFR exon T790M mutation
Your doctor may recommend osimertinib (Tagrisso) for the treatment of cancer with the EGFR exon T790M mutation.
Other EGFR inhibitors
Other EGFR inhibitors that doctors may recommend include:
- afatinib (Gilotrif), an oral medication
- necitumumab (Portrazza), which you receive by IV infusion
While most targeted therapies are used to treat adenocarcinomas, these medications are both appropriate for the treatment of squamous cell carcinomas.
Necitumumab (Portrazza) must be taken along with the chemotherapy drugs gemcitabine (Infugem) and cisplatin.
Other targeted therapies
Angiogenesis inhibitors block the growth of new blood vessels that help fuel cancer. They
These antibody treatments are given as IV infusions. You may need to take them alongside chemotherapy medications.
It’s generally easier to treat cancer before it spreads. Schedule an appointment with a healthcare professional as soon as possible if you have:
- a raspy voice or persistent cough
- chest pain
- shortness of breath and wheezing
- other symptoms of lung cancer
If you smoke, ask a doctor whether you should have regular lung cancer screenings.
Lung cancer is treatable, and the use of targeted therapies has improved the outlook for people with EGFR lung cancer.
However, while EGFR inhibitors can control cancer progression for months or years, they’re not a cure.
Your individual outlook will depend on a variety of factors, such as:
- the cancer stage at diagnosis
- your age and overall health
- how well the treatments work
Your doctor will review all your medical information and give you a clearer picture of what to expect.
Learn more about the outlook for NSCLC.
EGFR-positive lung cancer is a subtype of non-small cell lung cancer (NSCLC). Adenocarcinoma, a type of NSCLC, is the most common type to be EGFR positive. Other types include squamous cell carcinoma and large cell carcinoma.
In the beginning, EGFR-positive lung cancer may not cause any symptoms. As the condition progresses, you may experience symptoms such as shortness of breath, a hoarse voice, coughing, and wheezing.
Treatments for EGFR-positive lung cancer will likely include surgery or targeted therapy. Your doctor can advise on a suitable treatment plan and provide you with information about your outlook based on your individual circumstances.