183P - Epidermal growth factor receptor mutations in Italian non-small-cell lung cancer patients enrolled in the EGFR fastnet program

Date 30 September 2012
Event ESMO Congress 2012
Session Poster presentation II
Topics Biomarkers
Non-Small-Cell Lung Cancer, Metastatic
Presenter Nicola Normanno
Authors N. Normanno1, C. Pinto2, G.L. Taddei3, G. Troncone4, P. Graziano5, G. De Maglio6, M. Mottolese7, M. Di Maio8, C. Clemente9, A. Marchetti10
  • 1Dept. Biologia Cellulare E Bioterapie, Istituto Nazionale Tumori di Napoli, 80131 - Napoli/IT
  • 2Medical Oncology, Policlinico S.Orsola Malpighi, Bologna/IT
  • 3Surgical Pathology, Università degli Studi di Firenze, Firenze/IT
  • 4Surgical Pathology, Università Federico II, Napoli/IT
  • 5Surgical Pathology, Az.Osp. S.Camillo Forlanini, Roma/IT
  • 6Surgical Pathology, Az. Osp. Universitaria, S.Maria della Misericordia, Udine/IT
  • 7Surgical Pathology, Istituto Nazionale Tumori Regina Elena, Roma/IT
  • 8Clinical Trials Unit, Istituto Nazionale Tumori di Napoli, IT-80131 - Napoli/IT
  • 9Surgical Pathology, IRCCS Policlinico S.Donato e Casa di Cura S. Pio X, Milano/IT
  • 10Surgical Pathology, Università G.d’Annunzio, Chieti/IT



Assessment of epidermal growth factor receptor (EGFR) mutations is mandatory for appropriate selection of treatment for patients (pts) with advanced non-small-cell lung cancer (NSCLC).


The EGFR FASTnet program was designed to facilitate the exchange of biological material, clinico-pathological data and reports between medical oncologists, pathologists and referral laboratories. EGFR mutational analysis was carried by Sanger sequencing, Real Time (RT)-PCR, Pyrosequencing, and other techniques. The Italian Association of Medical Oncology (AIOM) and the Italian Society of Pathology and Cytopathology - Italian division of International Academy of Pathology (SIAPeC-IAP) have full access to the anonymous EGFR FASTnet database.


As of December 31, 2011, 503 oncologists, 135 pathologists and 38 referral laboratories joined the EGFR FASTnet program. The enrolled cohort of 3819 pts with advanced NSCLC was significantly enriched for adenocarcinoma histology (3172 [83%]), female sex (1361 [36%]) and smoking history (never smoker 911 [24%], former smoker > 15 yrs 880 [23%], light smoker 194 [5%]). Mutational analysis was feasible in 3567 pts (93%), and was carried by Sanger sequencing in 2021 cases (57%), RT-PCR in 174 (5%), Pyrosequencing in 636 (18%) and other techniques in 736 (21%). EGFR mutations were found in 520 cases (14.6%): 334 in exon 19 (9.4%), 163 in exon 21 (4.6%), 7 in exon 18 (0.2%) and 16 in exon 20 (0.4%). Proportion of mutated cases was slightly higher with RT-PCR (p = 0.049). A higher mutation rate was found in never smokers (32.0%), light smokers (18.7%) and former smokers >15 yrs (12.4%), as well as in adenocarcinoma (15.7%) and females (25.2%). EGFR mutations were also reported in 17/227 (7.5%) squamous carcinomas. However, 16/17 EGFR mutation positive patients with squamous carcinoma were never- or former-smokers.


The pts for EGFR mutational screening are spontaneously selected by medical oncologists according to known predictive factors. The results of the mutational analysis from clinical practice in Italy are consistent with data from literature. Never- and former-smoker NSCLC pts with squamous carcinoma should be tested for EGFR mutations.


All authors have declared no conflicts of interest.