Abstract

BackgroundEpidermal growth factor receptor (EGFR) gene alterations and amplification are frequently reported in cases of glioblastoma (GBM). However, EGFR-activating mutations that confer proven sensitivity to tyrosine kinase inhibitors (TKIs) in lung cancer have not yet been reported in GBM.Case presentationUsing next-generation sequencing, array comparative genomic hybridization and droplet digital PCR, we identified the p.L861Q EGFR mutation in a case of GBM for the first time. The mutation was associated with gene amplification. L861Q may be a clinically valuable mutation because it is known to sensitize non-small-cell lung cancers to treatment with the second-generation EGFR TKI afatinib in particular. Furthermore, we used slice culture of the patient’s GBM explant to evaluate the tumour’s sensitivity to various EGFR-targeting drugs. Our results suggested that the tumour was not intrinsically sensitive to these drugs.ConclusionsOur results highlight (i) the value of comprehensive genomic analyses for identifying patient-specific, targetable alterations, and (ii) the need to combine genomic analyses with functional assays, such as tumour-derived slice cultures.

Highlights

  • Epidermal growth factor receptor (EGFR) gene alterations and amplification are frequently reported in cases of glioblastoma (GBM)

  • When comparing the results for samples from the same run, we found that the number of reads for each EGFR exon was much higher in the patient’s

  • We used panel-based Next-generation sequencing (NGS) and droplet-based digital PCR (ddPCR) to identify the exon 21 p.L861Q EGFR mutation for the first time in a case of IDH-wild type (WT) GBM. This somatic point mutation was associated with EGFR gene amplification, as revealed by NGS and Array comparative genomic hybridization (aCGH) experiments (Table 1 and Fig. 1)

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Summary

Conclusions

Our results highlight (i) the value of comprehensive genomic analyses for identifying patient-specific, targetable alterations, and (ii) the need to combine genomic analyses with functional assays, such as tumour-derived slice cultures.

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