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  7. EGFR

EGFR and Lung Cancer

Testing for EGFR helps your doctor understand your lung cancer and choose treatments that may better work for you.

At a Glance:

  • EGFR is a common lung cancer biomarker
  • Testing can help match you to the best treatment plan for your cancer
  • You can ask for testing during diagnosis or if the cancer starts to change over time.

Frequently Asked Questions about Biomarker Testing

What Is EGFR?

EGFR, which stands for epidermal growth factor receptor, is a gene or protein involved in how cells grow. Changes (or mutations) in this biomarker can cause cancer cells to grow or spread.

Common mutation types: 

  • EGFR exon 19 deletions
  • EGFR L858R point mutations

These specific types of EGFR mutations tell doctors exactly where the change occurred in the DNA. 

In addition to these common mutations, there are rarer EGFR mutations that are tested for in lung cancer that may require different treatment. One major example of this in is EGFR exon 20 insertions mutations, which does not respond to the typical treatment for EGFR-positive lung cancer. 

Who is likely to have EGFR-positive lung cancer?

EGFR-positive lung cancer represents about 10-15% of lung cancers in the United States and most often appears in the adenocarcinoma subtype of non-small cell lung cancer (NSCLC). The incidence of EGFR-positive lung cancer is higher in Asian populations. Patients with lung cancers with EGFR mutations typically have a minimal to no smoking history, although, EGFR mutations can appear in patients with other types of lung cancer (e.g., squamous NCSCLC) and those with smoking histories. 

Why EGFR Testing Is Important 

Knowing whether you’re EGFR‑positive helps your care team choose targeted medicines that can work better and cause fewer side effects than standard chemotherapy. It also guides future treatment if the cancer changes over time. 

Biomarker testing looks for specific genetic changes in the tumor to help guide treatment. Testing includes DNA-based tests to identify changes in the genes themselves, and RNA-based tests to measure how those genes behave, giving your care team a fuller picture of your tumor makeup and available treatment options.

When Should You Get EGFR Testing?

EGFR testing should happen when: 

  • When you receive a biopsy for lung cancer diagnosis and staging
  • If you have been diagnosed with lung cancer and did not receive or learn about biomarker testing during diagnosis
  • If your cancer changes over time

How Is EGFR Testing Done?

Testing is usually done at diagnosis or when treatment changes. Your doctor will need to test your tumor through a tissue or blood (liquid) biopsy. There are several different types of tests that doctors use to look for changes, or biomarkers in your cells:

A common genetic test is called the Fluorescence in Situ Hybridization, or FISH, analysis. FISH analysis looks at changes in the chromosomes through tissue under a microscope.

Immunohistochemistry (IHC) looks for proteins in the cell under a microscope.

Next-generation sequencing (NGS), also called comprehensive biomarker testing, is when tissue from a patient's tumor (gathered from a biopsy) is placed in a machine that looks for many possible biomarkers at one time.

Reverse transcription polymerase chain reaction (RT-PCR) is a laboratory method used to make many copies of a specific genetic sequence for analysis.

Your doctor may perform several of these tests at the same time to help confirm results. Different biomarkers rely more heavily on certain tests.

Testing for EGFR mutations is usually done with NGS or PCR‑based tests, which look for specific changes in the EGFR gene. These tests identify mutations such as exon 19 deletions or L858R. Liquid biopsy can detect EGFR mutations when tissue is unavailable.  

Learn more about the different types of biomarker tests. 

Understanding Your Test Results & Next Steps

  • EGFR‑positive: EGFR Inhibitors, chemotherapy, and combination therapy treatment options may be available. EGFR-positive lung cancer caught at an early stage may often be treated with surgery to remove the tumor. Treatment for later-stage EGFR-positive lung cancer depends on the type of EGFR mutation present and how the cancer progresses.
  • EGFR‑negative: you may have other biomarkers that can inform different treatment options. When no actionable biomarkers are found, treatment usually focuses on immunotherapy, chemotherapy, or a combination of both. Doctors choose based on the cancer type, stage, and PD‑L1 level. Even without biomarkers, many effective treatment options exist, and your care team will tailor the plan to your situation.
  • Unclear result: you may need more or repeat testing.

Your results help guide next steps. There is always a plan, even if EGFR is not found. 

Talking to Your Doctor

Work with your doctor to discuss your goals and options each time you have to review and interpret test results to make a treatment decision. The three big questions to ask are:

  • What is the goal of this treatment?
  • What are the potential side effects?
  • What other options do I have?

Research is happening at a rapid pace, and your doctor should be up to date on the recommendations for your specific type of lung cancer. If you don’t feel comfortable with the answers you are receiving, do not hesitate to seek out a second opinion.

Treatment Options If You Have an EGFR Mutation

If your cancer is EGFR-positive, your doctor may recommend targeted therapy. These treatments focus on cancer cells and often have different side effects than chemotherapy.
Learn more about specific EGFR treatments

In this video, Dr. Lecia Sequist discusses the future of treatment for EGFR-positive lung cancer. This video was produced in 2021. For the latest treatment options, speak with your doctor.

Video transcript

What You Can Do Next 

Someone with an EGFR‑positive lung cancer diagnosis can take several empowering steps to stay ahead of their care. These are general medical information steps, not personal medical directives, and it’s important to work closely with a qualified healthcare professional for decisions about diagnosis or treatment.

Comprehensive testing ensures that all relevant EGFR alterations (such as exon 19 deletions, L858R, or uncommon mutations) are identified. It also checks for co‑alterations that may influence treatment choices.

Different EGFR mutations respond to different targeted therapies. Knowing which treatments are approved for your specific mutation helps you and your care team choose the most effective approach.

EGFR‑positive lung cancers have a higher likelihood of spreading to the brain. Regular imaging, often MRI, may be recommended to detect issues early, even if you have no symptoms. 

GFR‑targeted therapies can cause specific side effects such as rash, diarrhea, or nailbed changes. Tracking them helps your care team adjust treatment, manage symptoms, and maintain quality of life.

If the cancer progresses, repeat biomarker testing can identify resistance mutations (such as EGFR T790M or others) that may open the door to new treatment options.

Clinical trials may offer access to next‑generation EGFR inhibitors, combination therapies, or novel approaches for uncommon mutations or resistance patterns. 

Regular, open communication helps ensure your treatment plan stays aligned with your goals, symptoms are managed promptly, and any new concerns are addressed quickly.

EGFR FAQs

Being EGFR‑positive means your lung cancer has a change in the EGFR gene that helps the cancer grow. The good news is that there are targeted medicines designed specifically to block this change, which can slow the cancer and help you feel better. 

EGFR testing is recommended for anyone diagnosed with non‑small cell lung cancer, especially adenocarcinoma. It helps doctors choose the most effective treatment. Testing is done on tumor tissue or a blood‑based liquid biopsy. 

Yes. EGFR mutations can change as the cancer adapts to treatment. This is called “resistance.” If the cancer grows again, repeat biomarker testing can help identify new changes and guide the next treatment step. 

Most EGFR‑positive lung cancers are not inherited. They happen in the tumor itself, not in the genes you were born with. Inherited EGFR mutations are extremely rare. If you’re concerned, a doctor or genetic counselor can explain hereditary risk. 

Yes. Some people have EGFR plus other biomarkers, such as TP53 or MET changes. These can influence how the cancer behaves or responds to treatment. Comprehensive biomarker testing helps your care team understand the full picture.

Patient Experiences

Advice for Newly Diagnosed EGFR-Positive Lung Cancer Patients

In the videos below, patients share their advice for people newly diagnosed with EGFR-positive lung cancer, including the importance of hope, self-advocacy, support, and exploring available treatment options.

EGFR-positive lung cancer patient, Ashley.
EGFR-positive lung cancer patient, Mike.

Video transcripts

You Are Not Alone

Learning about biomarkers can feel overwhelming. Support is available. 

Lung cancer research can move at a rapid pace. Always speak with your doctor about the most up-to-date treatment guidelines.

Medically reviewed by: Jorge Gomez, MD

Last reviewed: June, 2026 

Page last updated: July 29, 2026

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