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- W2898420087 abstract "Genotype directed therapy has become increasingly important for personalized therapy of patients with advanced non-small cell lung cancer(NSCLC),but obtaining tumor tissue for genetyping remains a challenge.Plasma circulating tumor DNA(ctDNA) analysis by next-generation sequencing (NGS)may allow for noninvasive evaluation.We demonstrate the feasibility and clinical utility of ctDNA NGS in the management of advanced NSCLC. A total of 114 plasma samples were detected by NGS to identify actionable oncogenic driver mutations or mechanisms of resistance in 108 patients with advanced NSCLC.Among those 108 patients,there were 79 paired tissue DNA (tDNA) detected using ARMS PCR,We also evaluated the concordance in detecting of EGFR between ctDNA and paired tDNA. Of the 114 plasma ctDNA , 47(47/114,41%) actionable somatic mutations and 1 EGFR T790M germline mutation were dectected.EGFR variants were most common(39/114,34%).Among the 79 patients with matched tDNA and ctDNA, 32(32/79,41%)therapeutically targetable EGFR mutations were detected in tDNA and 30(30/79,38%) in ctDNA samples, yielding an overall concordance of 70%,the sensitivity and specificity of NGS were 59% and 77%.Of the 47patients with tDNA negative,11(11/47,23%)patients harbored EGFR mutation detected in ctDNA during the course of their disease.Of the 31 patients with brain metastases,22(71%)harbored an EGFR sensitive mutation(15,48%EGFR 19del and 7,23%EGFR L858R).Of the 40 patients who resistant to 1st and 2nd EGFR-TKI therapy,14(14/40,35%) showed the T790M acquired resistance mutation.the mean time of EGFR-TKI resistance was 11.5months.Patients with T790M mutations had significantly better PFS than those without T790M. CtDNA NGS can be adopted as a tool for providing precision genomic analysis and dynamic monitoring, thus improving patient management, and even,undertaking hereditary counseling." @default.
- W2898420087 created "2018-11-02" @default.
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- W2898420087 date "2018-10-01" @default.
- W2898420087 modified "2023-09-29" @default.
- W2898420087 title "P2.01-130 Detection of Actionable Mutation Status in Advanced Non-Small Cell Lung Cancer by Next-Generation Sequencing of Circulating Tumor DNA" @default.
- W2898420087 doi "https://doi.org/10.1016/j.jtho.2018.08.1185" @default.
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