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Combining Plasma and Tissue Genotyping in EGFR-Mutant Lung Cancer

By: Hillary Ojeda
Posted: Wednesday, June 5, 2019

A combination of liquid biopsy and tissue rebiopsy for EGFR T790M genotyping may benefit patients with non–small-cell lung cancer (NSCLC) who develop progressive disease after first-generation tyrosine kinase inhibitor therapy. These study findings were published in Molecular Oncology by Bing Wei, MD, of the Henan Cancer Hospital, China, and colleagues.  

“Our result supports the clinical utility of the combination strategy in the real world, as the overall T790M-positive rate, and [objective response rate and disease control rate] for osimertinib, were all consistent with data published with clinical trials,” the study authors concluded.

A total of 375 patients were enrolled in the retrospective study. They had advanced or recurrent NSCLC, recorded an EGFR-activating mutation, received first-generation EGFR- tyrosine kinase inhibitors, developed progressive disease, and had either rebiopsy or liquid biopsy at Henan Cancer Hospital in China between January 2016 and January 2017. The investigators reviewed the patients’ data and the clinical aspects that impacted T790 detection. They developed a strategy of using tissue rebiopsy primarily and using liquid biopsies if tissue rebiopsy was not possible.

“Our results suggested that primary EGFR 19del, brain metastasis, and longer progression-free survival of initial EGFR-[tyrosine kinase inhibitor] treatment are associated with acquired T790M resistance,” Dr. Wei and colleagues commented. “T790M-positive patients significantly benefited from osimertinib.”

Disclosure: The study authors reported no conflicts of interest.



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