Epidermal growth factor receptor gene in primary tumor and metastatic sites from non-small cell lung cancer

Lorenzo Daniele, Paola Cassoni, Elisa Bacillo, Susanna Cappia, Luisella Righi, Marco Volante, Fabrizio Tondat, Giorgio Inghirami, Anna Sapino, Giorgio V. Scagliotti, Mauro Papotti, Silvia Novello

Research output: Contribution to journalArticle


Introduction: The majority of patients with non-small cell lung cancer (NSCLC) develop distant metastases. Epidermal growth actor receptor (EGFR) tyrosine kinase inhibitors are capable of reducing brain and adrenal metastases. However, the EGFR status may be discordant between primary NSCLC and the corresponding metastases. Methods: Using fluorescence in situ hybridization (FISH) analysis, the EGFR gene status was evaluated in a series of 38 cerebral or adrenal metastases collected from two institutions and in the corresponding primary tumors. Also, EGFR mutational analysis was performed using direct sequencing on the cerebral metastases. Results: EGFR FISH was positive in 28% of the primary tumors and in 45% of the metastases (p <0.05). Among the seven cases FISH-positive at the metastatic site but negative in the primary tumor, six were brain metastases, and one was an adrenal metastasis; all were polysomic for chromosome 7, none were amplified. No EGFR mutations have been found in the cerebral metastases. Conclusion: Because the molecular asset of EGFR may change during the metastatic progression of NSCLC to brain (but not to adrenal), the selection of patients with brain metastasis for specific targeted therapies by EGFR FISH analysis should be performed on metastatic lesions rather than on their corresponding primary tumors.

Original languageEnglish
Pages (from-to)684-688
Number of pages5
JournalJournal of Thoracic Oncology
Issue number6
Publication statusPublished - Jun 2009



  • Brain metastases
  • EGFR polysomy
  • FISH
  • Lung cancer

ASJC Scopus subject areas

  • Medicine(all)
  • Oncology
  • Pulmonary and Respiratory Medicine

Cite this

Daniele, L., Cassoni, P., Bacillo, E., Cappia, S., Righi, L., Volante, M., Tondat, F., Inghirami, G., Sapino, A., Scagliotti, G. V., Papotti, M., & Novello, S. (2009). Epidermal growth factor receptor gene in primary tumor and metastatic sites from non-small cell lung cancer. Journal of Thoracic Oncology, 4(6), 684-688. https://doi.org/10.1097/JTO.0b013e3181a52359