P2.03-016 Clinical Utility of Liquid Biopsy for Detecting EGFR T790M Mutation Is Very Limited

BACKGROUND: A histopathological and mutational diagnosis has become a priority in the correct choice of the most appropriate cancer therapy for NSCLC. In the absence of a molecular analysis, the therapeutic choice will be directed towards platinum-based chemotherapy, thus preventing, in the presence of a specific mutation, the benefits deriving from the administration of a target therapies (TT).AIM: the present analysis was carried out with the aim of estimating the clinical impact, expressed in terms of progression free survival (PFS), associated with the use of the combined strategy (tissue biopsy and liquid biopsy) or the tissue strategy in the EGFR+ mNSCLC population.METHODS: A pre-existing cost-consequence model was adapted to estimate the annual number of mNSCLC patients with or without the EGFR mutation in order to decide the oncological treatment to be administered in first (1L) or second line (2L). In 1L, against the presence of the EGFR mutation, the administration of a Tyrosine Kinase Inhibitor (TKI), such as osimertinib, gefitinib, erlotinib or afatinib, was considered; in the absence of the EGFR mutation, the administration ofstandard platinum-based chemotherapy was instead considered. With reference to 2L, in the presence of the EGFR T790M mutation, only osimertinib was considered. In the absence of the EGFR T790M mutation, the administration of the standard platinum-based chemotherapy was also considered. The PFS data associated with each of the drugs considered were extrapolated from the respective clinical studies. Key variables were tested in the sensitivity analysis.RESULTS: The adoption of the combined strategy (tissue biopsy and liquid biopsy), by virtue of a greater number of patients treated with TKIs, would make it possible to increase the average PFS in the range of 1.1-3,7 months in the 1L and by 1.4 months in the 2L.CONCLUSION: These results show how the adoption of a correct diagnostic strategy is critical in order to optimize the choice of the therapeutic path in the 1L and 2L of mNSCLC. The addition of the liquid biopsy to the classic diagnostic path (tissue biopsy) would in fact allow to obtain an increase in therapeutic efficacy (average PFS).

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Clinical utility of liquid biopsy for EGFR driver, T790M mutation and EGFR amplification in plasma in patients with acquired resistance to afatinib

10.21203/rs.3.rs-53232/v2 ◽

2020 ◽

Author(s):

Yuko Oya ◽

Tatsuya Yoshida ◽

Kazuhiro Asada ◽

Tetsuya Oguri ◽

Naoki Inui ◽

...

Keyword(s):

Liquid Biopsy ◽

Clinical Utility ◽

Detection Rate ◽

Kinase Inhibitors ◽

Acquired Resistance ◽

First Line ◽

T790m Mutation ◽

Significant Difference ◽

Droplet Pcr ◽

Line Setting

Abstract Background: Cell-free DNA (cfDNA) genotyping in plasma using the cobas EGFR Mutation Test v2 (cobas) is the first liquid biopsy as a companion diagnosis to identify the EGFR T790M mutation (T790M) after the failure of treatment of EGFR-tyrosine kinase inhibitors (TKIs) (1st generation, gefitinib [G] and erlotinib [E] and 2nd generation, afatinib [A]). This study investigated the clinical utility of a liquid biopsy for patients who acquired resistance to afatinib.Methods: We prospectively collected plasma from 51 patients who had acquired resistance to afatinib between April 2015 and November 2016 to evaluate the frequency of T790M by cobas and digital droplet PCR (UMIN000025112). Additionally, we retrospectively reviewed 38 patients who tested by cobas in plasma after G/E failure to compare for T790M detection between A and with G/E.Results: The detection rate of EGFR-driver and T790M in plasma in patients treated with A (A group) as a first-line EGFR-TKI was lower than with G/E followed by A (G/E→A group), although the differences were not significant (EGFR-driver: 41% [A] vs. 67% [G/E→A], P=0.1867; and T790M: 8% [A] vs. 17% [G/E→A], P=0.5798). In first-line setting, the detection rate for EGFR-driver and T790M in plasma by cobas was lower in A group than in G/E group, although there was no significant difference (EGFR-driver: 34% [A] vs. 52% [G/E], P=0.2072; and T790M: 10% [A] vs. 27% [G/E], P=0.1161).Conclusion: The detection of EGFR-driver and T790M in plasma by cobas in patients treated with afatinib might be lower than with G/E in a real-world setting.

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P14 Detection of EGFR/T790M Mutation in Advanced NSCLC Post TKI Treatment: First Experience of Liquid Biopsy in Argentina

Journal of Thoracic Oncology ◽

10.1016/j.jtho.2018.07.053 ◽

2018 ◽

Vol 13 (9) ◽

pp. S166-S167

Author(s):

M.C. Mosqueira ◽

S. Anchordoqui ◽

R. Martínez Correa ◽

E. Pichelbauer ◽

A. Trinchero ◽

...

Keyword(s):

Liquid Biopsy ◽

Advanced Nsclc ◽

T790m Mutation ◽

Tki Treatment ◽

Egfr T790m

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Clinical utility of liquid biopsy for EGFR driver, T790M mutation and EGFR amplification in plasma in patients with acquired resistance to afatinib

BMC Cancer ◽

10.1186/s12885-020-07777-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yuko Oya ◽

Tatsuya Yoshida ◽

Kazuhiro Asada ◽

Tetsuya Oguri ◽

Naoki Inui ◽

...

Keyword(s):

Liquid Biopsy ◽

Clinical Utility ◽

Detection Rate ◽

Kinase Inhibitors ◽

Acquired Resistance ◽

First Line ◽

T790m Mutation ◽

Significant Difference ◽

Droplet Pcr ◽

Line Setting

Abstract Background Cell-free DNA (cfDNA) genotyping in plasma using the cobas EGFR Mutation Test v2 (cobas) is the first liquid biopsy as a companion diagnosis to identify the EGFR T790M mutation (T790M) after the failure of treatment of EGFR-tyrosine kinase inhibitors (TKIs) (1st generation, gefitinib [G] and erlotinib [E] and 2nd generation, afatinib [A]). This study investigated the clinical utility of a liquid biopsy for patients who acquired resistance to afatinib. Methods We prospectively collected plasma from 51 patients who had acquired resistance to afatinib between April 2015 and November 2016 to evaluate the frequency of T790M by cobas and digital droplet PCR (UMIN000025112). Additionally, we retrospectively reviewed 38 patients who tested by cobas in plasma after G/E failure to compare for T790M detection between A and with G/E. Results The detection rate of EGFR-driver and T790M in plasma in patients treated with A (A group) as a first-line EGFR-TKI was lower than with G/E followed by A (G/E→A group), although the differences were not significant (EGFR-driver: 41% [A] vs. 67% [G/E→A], P=0.1867; and T790M: 8% [A] vs. 17% [G/E→A], P=0.5798). In first-line setting, the detection rate for EGFR-driver and T790M in plasma by cobas was lower in A group than in G/E group, although there was no significant difference (EGFR-driver: 34% [A] vs. 52% [G/E], P=0.2072; and T790M: 10% [A] vs. 27% [G/E], P=0.1161). Conclusion The detection of EGFR-driver and T790M in plasma by cobas in patients treated with afatinib might be lower than with G/E in a real-world setting.

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A highly sensitive real-time PCR assay for detecting EGFR T790M mutation in liquid biopsy samples

10.26226/morressier.5b4709896f4cb30010951994 ◽

2018 ◽

Author(s):

Christian Oberkanins

Keyword(s):

Real Time ◽

Real Time Pcr ◽

Liquid Biopsy ◽

Pcr Assay ◽

T790m Mutation ◽

Highly Sensitive ◽

Egfr T790m

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Clinical Utility of Liquid Biopsy for EGFR Driver, T790M Mutation and EGFR Amplification in Plasma in Patients with Aacquired Resistance to Afatinib

10.21203/rs.3.rs-53232/v1 ◽

2020 ◽

Author(s):

Yuko Oya ◽

Tatsuya Yoshida ◽

Kazuhiro Asada ◽

Tetsuya Oguri ◽

Naoki Inui ◽

...

Keyword(s):

Liquid Biopsy ◽

Clinical Utility ◽

Detection Rate ◽

Kinase Inhibitor ◽

Acquired Resistance ◽

T790m Mutation ◽

Significant Difference ◽

Droplet Pcr ◽

Line Setting ◽

Egfr Tki

Abstract Background: Cell-free DNA (cfDNA) genotyping in plasma using the cobas EGFR Mutation Test v2 (cobas) is the first liquid biopsy as a companion diagnosis to identify the EGFR T790M mutation (T790M) after the failure of treatment of EGFR-tyrosine kinase inhibitor (TKI) (1st generation, gefitinib [G] and erlotinib [E] and afatinib [A]). This study investigated the clinical utility of a liquid biopsy for patients who acquired resistance to afatinib.Methods: We prospectively collected plasma from 51 patients who had acquired resistance to afatinib between April 2015 and November 2016 to evaluate the frequency of T790M using the cobas and digital droplet PCR (UMIN000025112). Additionally, we retrospectively reviewed 38 patients who tested by cobas in plasma after G/E failure to compare for T790M detection between A and with G/E.Results: The detection rate of EGFR sensitive mutation (EGFR sens.) and T790M in plasma in patients treated with A (A group) as an initial EGFR-TKI was lower than with G/E followed by A (G/E→A), although the differences were not significant (EGFR sens.: 41% (A) vs. 67% (G/E→A), P=0.1867; and T790M: 8% (A) vs. 17% (G/E→A), P=0.5798). In first-line setting, the detection rate for EGFR-sens. and T790M in plasma by cobas was lower in A group than in G/E group, although there was no significant difference (EGFR sens.: 34% (A) vs. 52% (G/E), P=0.2072; and T790M: 10% (A) vs. 27% (G/E), P=0.1161).Conclusion: The detection of EGFR sens. and T790M in plasma by cobas might be insufficient in patients treated with afatinib than with G/E.

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