https://scholars.lib.ntu.edu.tw/handle/123456789/473820
標題: | Effusion immunocytochemistry as an alternative approach for the selection of first-line targeted therapy in advanced lung adenocarcinoma | 作者: | TZU-HSIU TSAI SHANG-GIN WU YIH-LEONG CHANG CHEN-TU WU Tsai M.-F. Wei P.-F. CHIH-HSIN YANG CHONG-JEN YU PAN-CHYR YANG JIN-YUAN SHIH |
公開日期: | 2012 | 出版社: | Lippincott Williams and Wilkins | 卷: | 7 | 期: | 6 | 起(迄)頁: | 993-1000 | 來源出版物: | Journal of Thoracic Oncology | 摘要: | Introduction: Tumor tissue is often not obtainable or suitable for molecular-based epidermal growth factor receptor (EGFR) mutational analysis in advanced non-small-cell lung cancer (NSCLC). This retrospective and single-institution study was conducted to evaluate the role of effusion immunocytochemistry using two EGFR mutant-specific antibodies for the detection of relevant EGFR mutations in NSCLC, along with the selection of candidates for first-line therapy with EGFR tyrosine kinase inhibitors (TKIs). METHODS: Immunocytochemistry using two antibodies binding specifically to the major forms of mutant EGFR, L858R, and E746-A750 deletion (delE746-A750), was performed on cell blocks of malignant pleural effusion (MPE) from 78 patients with lung adenocarcinoma, who received first-line EGFR TKIs. The yield of EGFR-mutation detection and prediction of response rate and progression-free survival to TKI treatment by immunocytochemistry were compared with those by clinical characteristics and EGFR sequencing using cell-derived RNA from MPEs. RESULTS: Of the 78 MPE samples, direct sequencing using cell-derived RNA identified L858R mutation in 42 cases, deletions in exon 19 in 12 cases (delE746-A750 in eight cases), other types of mutations in three cases, and wild-type EGFR in 21 cases. Effusion immunocytochemistry with these two mutant-specific antibodies exhibited a sensitivity of 71% and 88% and a specificity of 86% and 96% for identifying predefined L858R and delE746-A750 mutations, respectively. Effusion immunocytochemistry provided a superior prediction of tumor response and progression-free survival to first-line EGFR TKIs than did clinical characteristics like sex and smoking status. Patients whose effusion immunocytochemistry showed a reaction to either of the two antibodies had a comparable TKI response rate (67% versus 72%) to those with EGFR mutations assessed by direct sequencing from cell-derived RNA. CONCLUSIONS: Effusion immunocytochemistry could be introduced into clinical practice to identify more NSCLC patients likely to have benefit from first-line TKI treatment, especially for those without adequate tissue for molecular-based EGFR analysis. Copyright ? 2012 by the International Association for the Study of Lung Cancer. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84861338508&doi=10.1097%2fJTO.0b013e31824cc46b&partnerID=40&md5=1a0966a2fd70c19aa4e5afa0d70e5738 https://scholars.lib.ntu.edu.tw/handle/123456789/473820 |
ISSN: | 1556-0864 | DOI: | 10.1097/JTO.0b013e31824cc46b | SDG/關鍵字: | epidermal growth factor receptor; erlotinib; gefitinib; adult; advanced cancer; aged; antibody combining site; article; clinical practice; controlled study; cytopathology; exocrine cell; exon; female; gene deletion; gene mutation; human; human cell; immunocytochemistry; immunohistochemistry; immunoreactivity; lung adenocarcinoma; lung non small cell cancer; major clinical study; male; overall survival; pleura effusion; predictive value; priority journal; progression free survival; retrospective study; sensitivity and specificity; sequence analysis; smoking; treatment response; wild type |
顯示於: | 病理學科所 |
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