Genetic Heterogeneity in Patients with Multiple Neoplastic Lung Lesions: A Report of Three Cases

A comparison of EGFR and KRAS status in primary lung carcinoma and matched metastases

“…It is possible that primary tumors are heterogeneous with different clones giving rise to disseminated tumor cells with different molecular profiles than most of the primary tumor. This idea of heterogeneity within tumors has been theorized as one possible cause for different mutational profiles in primary and metastatic tumors in colorectal carcinogenesis [36] and in lung carcinogenesis [47][48][49][50]. In addition, tumor clone selection during the treatment protocol could also explain the discordant molecular signatures of primary and metastatic lesions; however, one study found that discordance in molecular profiles occurred irrespectively of administered chemotherapy [22].…”

A Subset of Lung Adenocarcinomas and Atypical Adenomatous Hyperplasia–Associated Foci Are Genotypically Related

“…These findings further highlight the genetic heterogeneity of multiple lung tumors occurring in the same patient. 79 In addition, one of these patients (case 7) was the only one undergoing treatment with EGFR TKI (erlotinib), but without clinical response. The patient started erlotinib treatment after the third tumor occurrence when molecular analysis showed a K-ras mutation in the lung tumor.…”

Discordance of Molecular Biomarkers Associated with Epidermal Growth Factor Receptor Pathway between Primary Tumors and Lymph Node Metastasis in Non-small Cell Lung Cancer

“…Studies of heterogeneity in tumors clearly show that there is extensive cytogenetic, genetic, and epigenetic variability in neoplastic cell populations in a variety of human cancers, 30,31 and the heterogeneity of cancer cell populations in different metastasis site was also has been described. 32,33 Previously, Reymond and coworkers 34 suggested that disseminated cancer cells are not always clonal with the primary tumor, when comparing the pattern of K-ras mutations between bone marrow micrometastases and corresponding primary tumor. Recently, several differential gene or protein expression studies have suggested that a selected population of disseminated cancer cells and the primary tumors express a considerable degree of heterogeneity.…”