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Combined plasma and tissue genotyping of EGFR T790M benefits NSCLC patients:A real-world clinical example.

08:00 EDT 29th March 2019 | BioPortfolio

Summary of "Combined plasma and tissue genotyping of EGFR T790M benefits NSCLC patients:A real-world clinical example."

Acquired resistance to EGFR-tyrosine kinase inhibitors (TKIs) is a prevalent clinical problem in the management of advanced non-small cell lung cancer (NSCLC) with TKI-sensitizing mutations in the EGFR gene. Third-generation EGFR-TKIs have demonstrated potent activity against TKI resistance mediated by the EGFR T790M mutation, and standard re-biopsy and liquid biopsy are utilized to assess the T790M status of the NSCLC patients who experienced progressive disease. Here, we conducted a retrospective study to assess 375 patients whose initial biopsy indicated a TKI-sensitizing mutation (either EGFR 19del or L858R) and who developed progressive disease after treatment with first-generation TKIs, and assayed for T790M status. We adopted a combination approach in which tissue re-biopsy is preferred, utilizing liquid biopsies when tissue re-biopsy is not feasible. We analyzed the potential predictive clinical factors affecting T790M detection, evaluated the standard re-biopsy and liquid biopsy methods in T790M genotyping, and reported the clinical performance of osimertinib. Our results suggested that primary EGFR 19del, brain metastasis, and longer progression-free survival of initial EGFR-TKI treatment are associated with acquired T790M resistance. T790M positive patients significantly benefited from osimertinib. In conclusion, the real-world clinical adoption of the combination approach with both tissue re-biopsy and liquid biopsy for T790M genotyping may provide significant benefits to patients who have developed progressive disease after first-generation TKI treatments.

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Name: Molecular oncology
ISSN: 1878-0261
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