EGFR, or epidermal growth factor receptor, is a protein that is important for proper cell growth and division. In some cases of non-small cell lung cancer, a mutation can cause EGFR to be overexpressed, resulting in uncontrolled cell growth. Roughly 15% of cases of non-small cell lung cancer in the United States involve an EGFR mutation.

The majority of EGFR mutations are somatic, meaning that changes in DNA occur during a person's lifetime instead of being inherited. These types of mutations may occur from smoking or secondhand smoke exposure, air pollution, asbestos or radon exposure, or exposure to certain metals or chemicals. EGFR mutations tend to affect certain populations more than others including people of Asian heritage, women, and individuals with lung adenocarcinoma. Less commonly, individuals can inherit a mutation in the EGFR gene known as T790M when they are born. This mutation can put those individuals at a higher risk for developing lung cancer.

Early EGFR positive lung cancer may not cause any symptoms. As the condition progresses, individuals may experience chronic cough, coughing up blood, shortness of breath, wheezing, fatigue, loss of appetite, unexplained weight loss, and chest pain. Symptoms that appear in the later stages of EGFR positive lung cancer may include hoarseness or changing voice, difficulty swallowing, eyelid drooping, facial swelling, nail abnormalities, bone, joint, and shoulder pain, and weakness.

Depending on the stage of EGFR positive lung cancer as well as the specific mutation involved, there are a variety of options available. If the cancer has not spread and is in an early stage, individuals may be able to undergo surgery to completely remove the cancer. There are also a variety of drug options called EGFR inhibitors that prevent unregulated cell growth. Some examples of EGFR inhibitors include Afatinib (Gilotrif), Erlotinib (Tarceva), Gefitinib (Iressa), Osimertinib (Tagrisso), Dacomitinib (Vizimpro), and Necitumumab (Portrazza). Treatment plans, including the type of EGFR inhibitor used, are typically specialized based on the specific EGFR mutation. Individuals with EGFR positive lung cancer may also be able to take part in clinical trials that offer newer or more experimental treatments.

Groups such as EGFR Resisters (https://egfrcancer.org/) offer support for individuals with EGFR positive lung cancer. There are also support groups that focus more generally on non-small cell lung cancer: Cancer Support Community: Non-Small Cell Lung Cancer - https://www.cancersupportcommunity.org/non-small-cell-lung-cancer American Lung Association, Lung Cancer Support Groups - https://www.lung.org/lung-health-diseases/lung-disease-lookup/lung-cancer/patients/find-support/support-groups

Many targeted treatments have been developed for EGFR positive lung cancer in recent years, which has given patients much more hope. Individuals who receive an early diagnosis and/or targeted treatments are likely to have the best outcomes.

Complications of EGFR positive lung cancer can include shortness of breath, fluid accumulation around the lung and in the chest (pleural effusion), coughing up blood (hemoptysis), pain, nausea, headache. There is also a chance that cancer can spread (metastasize) to other parts of the body through tissue, the lymph system, or blood.

It is important to call your doctor if you have symptoms of lung cancer, chronic cough, coughing up blood, shortness of breath, wheezing, fatigue, loss of appetite, unexplained weight loss, and chest pain, especially if you smoke. After receiving a non-small cell lung cancer diagnosis, individuals can undergo genetic testing to identify any genetic abnormalities such as EGFR mutations.