EGFR - Epidermal growth factor receptor

Running head: EGFR & NSCLC
EGFR & NSCLC
Name of the student
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EGFR & NSCLC1
Introduction
Lung cancer has been considered as the major reason for the death in the men and breast
cancer has been considered as the major reason for death in the women (Faehling et al., 2017).
There are two types of lunch cancer – NSCLC (Non-small cell lung cancer) and SCLC (Small
cell lung cancer). In the paper of Chang, Lim, Chang, Chen, Shih and Yu (2019), the researchers
have discussed about the NSCLC. The researchers have tried to prove that the EGFR (Epidermal
growth factor receptor) mutation results in the NSCLC. The EGFR gene is the manufacture
industry of the EGFR trans-membrane protein which acts as a receptor for the epidermal growth
factor family (EGF family) of extracellular protein ligands. It has been seen that in around 40–
80per cent NSCLCs, the EGFR mutation is the major cause (Keam et al., 2014). Though,
NSCLCs has been shown to have a number of mutations, majorly involving the mutation of the
EGFR and KRAS (Kutkowska, Porębska & Rapak, 2017). Along with these, there are two most
commonly mentioned mutations have been discussed which are Exon 19 deletion and L858R
mutation in exon 21 of the EGFR, as a result it predicts a good response to EGFR-TKI (tyrosine
kinase inhibitors) (Choi et al., 2018). Other than the exon 19 deletions and L858R EGFR
mutations, all the other type of mutations are measured as ‘uncommon mutations’. In the paper
of Chang, Lim, Chang, Chen, Shih and Yu (2019), the researchers have tried to investigate other
possible mutations that result in the NSCLC expect the mutations which have been already been
mentioned.

EGFR & NSCLC2
Methodology
For the following research, the researchers selected patients with NSCLC harboring
EGFR mutations within the year 2011 – 2017. The settings for conducting the research were
three hospitals - National Taiwan University Hospital, Far Eastern Memorial Hospital and
National Taiwan University Hospital all of which were located in Taiwan. The stage of the lung
cancer was determined using the 7th edition of American Joint Committee on Cancer staging
system. MassARRAY genotyping (Sequenom, San Diego, CA), polymerase chain reaction-direct
sequencing and e-cobas EGFR Mutation Test (Roche) were the tools using which the researchers
did EGFR mutation testing. Along with these, other EGFR mutations data and plasma circulating
tumour DNA test results were also accumulated.
Discussion
According to a report, the major reasons behind the occurrence of NSCLC except the
genetic mutations are smoking cigarettes, exposure to asbestos and certain paints or chemicals.
For the treatment of this disease, the patients were separated into two groups initially. One group
was given 250 mg of gefitinib/150 mg of erlotinib as the first line therapy and another group was
given 30 mg or 40 mg of afatinib relying on the decision of the doctor. During the EGFR-TKI
treatment, imaging techniques were also conducted, that is chest and brain CT during the period
of f 8 to 12 weeks and 2 - 4 weeks correspondingly. The best treatment plan was appraised using
the Response Evaluation Criteria in Solid Tumours, version 1.1. Further data were analyzed
using the Chi-square tests. Consistent variables were articulated as medians with range or
interquartile ranges (IQRs). The variances of progression-free survival (PFS) and overall survival
(OS) among the patient groups of gefitinib/erlotinib and afatinib were evaluated using the log