Case reportDetection of the EGFR mutation in exhaled breath condensate from a heavy smoker with squamous cell carcinoma of the lung
Introduction
Patients with squamous cell carcinoma of the lung had rarely epidermal growth factor receptor (EGFR) mutations especially in heavy smoker. Less than 5% of the squamous cell carcinoma carried EGFR mutation [1]. Actually, in recently published two papers which proved the first-line gefitinib was effective for the advanced non-small cell lung cancer harboring EGFR mutation, the squamous cell carcinoma was only one in 172 [2] and five in 225 patients [3]. We previously showed that measurement of exhaled breath condensate (EBC) biomarkers was a non-invasive and useful way to evaluate airway inflammation in patients with asthma [4]. A biomarker panel with oncogenes, suppressor genes, and protein factors using exhaled breath condensate (EBC) has been explored in lung cancer patients [5].
Section snippets
Case presentation
A 61-year-old male smoker (40 pack-years) presented with right chest pain. Radiograph and computed tomography of the chest revealed a cavitary mass in the right lower lobe (Fig. 1A and B). Flexible bronchoscopy revealed a tumor in the intermediate bronchus. A transbronchial biopsy showed squamous cell carcinoma. Magnetic resonance imaging of the brain showed multiple metastases. Although he underwent whole-brain irradiation, he had paralysis of the left side of the body and his performance
Discussion
Although only a small percentage of heavy smokers with squamous cell carcinoma harbor EGFR mutations [1], they may benefit from gefitinib treatment [2], [3]. Based on this experience, we have examined the EGFR mutation status in heavy smokers with squamous cell carcinoma.
We might have detected the EGFR mutation in EBC by chance, because Paradiso et al. reported that EBC could not be used to investigate somatic mutations of EGFR [7]. In addition, the previous reports revealed that sufficient
Conclusion
A male, heavy smoker with squamous cell carcinoma was treated successfully with first-line gefitinib. EGFR mutation status in the patients having such clinical features might be examined. This case was successfully evaluated its EGFR mutation status from EBC.
Conflict of interest
The authors have no conflict of interest.
References (10)
- et al.
Gefitinib versus cisplatin plus docetaxel in patients with non-small-cell lung cancer harbouring mutations of the epidermal growth factor receptor (WJTOG3405): an open label, randomised phase 3 trial
Lancet Oncol
(2010) - et al.
The impact of genetic markers on the diagnosis of lung cancer: a current perspective
J Thorac Oncol
(2007) - et al.
Clinical and biological features associated with epidermal growth factor receptor gene mutations in lung cancers
J Natl Cancer Inst
(2005) - et al.
Gefitinib or chemotherapy for non-small-cell lung cancer with mutated EGFR
N Engl J Med
(2010) - et al.
Inflammatory markers in exhaled breath condensate from patients with asthma
Respirology
(2008)
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