Is EGFR+ Lung Cancer Hereditary?

Epidermal growth factor receptor-positive (EGFR+) lung cancer is rare. It accounts for about 10 to 15 percent of lung cancers in the United States. There are several studies looking at whether EGFR+ lung cancer is hereditary. Hereditary cancers are caused by changes in certain genes (genetic variants, or mutations) passed from parents to children.^1,2

In hereditary cancer, patterns of cancer are seen within families. This means that several close family members (like a mother, daughter, and brother) are diagnosed with the same type of cancer. The cancer often develops at an early age. Sometimes, people get more than one cancer.²

Inheriting EGFR+ lung cancer mutations

EGFR is a protein found on cells. It helps the cells grow. But when the EGFR gene changes (mutates), it can cause them to grow too much. This overgrowth can cause cancer.¹

There are several possible genetic variants of the EGFR gene. The most common one is the L858R mutation. This is called a somatic mutation because changes happen to the gene during a person's life.^1,3

Another important mutation being studied is the T790M mutation. The T790M mutation happens on a sperm or egg cell. When the sperm and egg join during conception, the mutation passes to the child. Mutations that happen this way are called germline mutations. The T790M mutation is the most common germline mutation. It can be inherited from parents.^3,4

Research on EGFR+ lung cancer

There is existing and new research looking at how EGFR+ lung cancer may be hereditary. Because EGFR+ lung cancer is rare (especially with T790M mutation), many studies use small groups.^4-7

In 2020, a study looked at more than 65,000 people who had been given a germline hereditary cancer test. Only 29 people (0.04 percent) were carriers of the T790M mutation. A cancer history was available for 26 of these people. Of those 26, nearly 62 percent had a history of lung cancer or lung nodules.⁵

A review of over 50 research studies on inherited lung cancer was conducted in 2018. It found that:⁴

• Having a T790M mutation results in an increased lung cancer risk.
• People with a T790M mutation often have other EGFR somatic mutations (like L858R).
• More women than men have a T790M mutation.
• The T790M mutation often occurs in people who have never smoked.

Many studies have found mixed results when looking at race and germline T790M mutations. Some research suggests that East Asians are more likely to have this mutation.^6,7

Ongoing studies continue to look at EGFR+ lung cancer and hereditary gene mutations. It’s important to identify people who have genetic variants, especially germline mutations. This is because EGFR+ lung cancer from germline mutations does not respond to normal EGFR+ lung cancer treatment.⁶

Understanding how EGFR+ lung cancer may be inherited is important. It will lead to an improvement in treatments for people with this type of cancer.