Received on June 12, 2006
Accepted on October 23, 2006

Cancer Diagnostics

Detection of Epidermal Growth Factor Receptor Variations by Partially Denaturing HPLC

¹ Department of Haematology and Oncology, National University Hospital, Singapore
² Oncology Research Institute, National University of Singapore, Singapore
³ Oncology Research Institute and Department of Pathology, National University of Singapore, Singapore, and Department of Pathology, National University Hospital, Singapore
⁴ School of Surgery and Pathology, University of Western Australia, Western Australia, Perth, Australia
⁵ Department of Surgery, Kanazawa University School of Medicine, Kanazawa, Japan
⁶ Department of Anatomical Pathology, Pathwest, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
⁷ Oncology Research Institute and Department of Pathology, National University of Singapore, Singapore

^* To whom correspondence should be addressed. E-mail: nmirs{at}nus.edu.sg.

Background: Epidermal growth factor receptor gene (EGFR) variants may be useful markers for identifying responders to gefitinib and erlotinib, small-molecule tyrosine kinase inhibitors of EGFR; therefore, sensitive and cost-effective assays are needed to detect EGFR variants in routine clinical samples. We have developed a partially denaturing HPLC (pDHPLC) assay that is superior to direct sequencing with respect to detection limits, costs, and time requirements.

Methods: Primers, temperatures, and buffer conditions were optimized for PCR-pDHPLC analysis of EGFR exons 18-21. We evaluated the detection limits of pDHPLC and direct sequencing by analyzing mixtures of wild-type and variant EGFR DNA and screened 192 lung cancer samples to examine the diversity of pDHPLC-detectable variants. To assess amenability to routine analysis, we tested lung and pleural tissue specimens from 14 lung cancer patients treated with gefitinib.

Results: The detection limits for variant alleles were 1:100 for pDHPLC and 1:5 for direct sequencing. pDHPLC analysis detected 26 unique EGFR variants, including the common deletions in exon 19 and substitutions in codons 787 and 858. Direct sequencing could not identify 30% (18 of 60) of the variant amplicons identified by pDHPLC. We identified these 18 amplicons by fraction collection after pDHPLC analysis. Analysis of a limited series of lung biopsy samples detected EGFR variants more frequently in gefitinib responders than in nonresponders. pDHPLC analysis was 56% less expensive and 39% faster than direct sequencing.

Conclusions: pDHPLC-based analysis detects EGFR variations in routine clinical samples with a better detection limit and lower cost and time requirement than direct sequencing.