title: Consensus for EGFR mutation testing in non-small cell lung cancer: results from a European workshop.
abstract: BACKGROUND
  Activating somatic mutations of the tyrosine kinase domain of epidermal growth factor receptor (EGFR) have recently been characterized in a subset of patients with advanced non-small cell lung cancer (NSCLC). Patients harboring these mutations in their tumors show excellent response to EGFR tyrosine kinase inhibitors (EGFR-TKIs). The EGFR-TKI gefitinib has been approved in Europe for the treatment of adult patients with locally advanced or metastatic NSCLC with activating mutations of the EGFR TK. Because EGFR mutation testing is not yet well established across Europe, biomarker-directed therapy only slowly emerges for the subset of NSCLC patients most likely to benefit: those with EGFR mutations.
  
  
  METHODS
  The "EGFR testing in NSCLC: from biology to clinical practice" International Association for the Study of Lung Cancer-European Thoracic Oncology Platform multidisciplinary workshop aimed at facilitating the implementation of EGFR mutation testing. Recommendations for high-quality EGFR mutation testing were formulated based on the opinion of the workshop expert group.
  
  
  RESULTS
  Co-operation and communication flow between the various disciplines was considered to be of most importance. Participants agreed that the decision to request EGFR mutation testing should be made by the treating physician, and results should be available within 7 working days. There was agreement on the importance of appropriate sampling techniques and the necessity for the standardization of tumor specimen handling including fixation. Although there was no consensus on which laboratory test should be preferred for clinical decision making, all stressed the importance of standardization and validation of these tests.
  
  
  CONCLUSIONS
  The recommendations of the workshop will help implement EGFR mutation testing in Europe and, thereby, optimize the use of EGFR-TKIs in clinical practice.
authors.affiliation: Medical University of Vienna, Vienna, Austria. robert.pirker@meduniwien.ac.at
authors.forename: Robert
authors.initials: R
authors.lastname: Pirker
authors.forename: Felix J F
authors.initials: FJ
authors.lastname: Herth
authors.forename: Keith M
authors.initials: KM
authors.lastname: Kerr
authors.forename: Martin
authors.initials: M
authors.lastname: Filipits
authors.forename: Miquel
authors.initials: M
authors.lastname: Taron
authors.forename: David
authors.initials: D
authors.lastname: Gandara
authors.forename: Fred R
authors.initials: FR
authors.lastname: Hirsch
authors.forename: Dominique
authors.initials: D
authors.lastname: Grunenwald
authors.forename: Helmut
authors.initials: H
authors.lastname: Popper
authors.forename: Egbert
authors.initials: E
authors.lastname: Smit
authors.forename: Manfred
authors.initials: M
authors.lastname: Dietel
authors.forename: Antonio
authors.initials: A
authors.lastname: Marchetti
authors.forename: Christian
authors.initials: C
authors.lastname: Manegold
authors.forename: Peter
authors.initials: P
authors.lastname: Schirmacher
authors.forename: Michael
authors.initials: M
authors.lastname: Thomas
authors.forename: Rafael
authors.initials: R
authors.lastname: Rosell
authors.forename: Federico
authors.initials: F
authors.lastname: Cappuzzo
authors.forename: Rolf
authors.initials: R
authors.lastname: Stahel
mesh_terms: D014408:Biomarkers, Tumor / Q000235:genetics*; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis / Q000235:genetics* / Q000628:therapy; D002986:Clinical Trials as Topic; D066246:ErbB Receptors / Q000235:genetics*; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis / Q000235:genetics* / Q000628:therapy; D008403:Mass Screening; D009154:Mutation / Q000235:genetics*
chemical_list: D014408:Biomarkers, Tumor; C512478:EGFR protein, human; D066246:ErbB Receptors