https://scholars.lib.ntu.edu.tw/handle/123456789/507239
Title: | Dynamic plasma EGFR mutation status as a predictor of EGFR-TKI efficacy in patients with EGFR-mutant lung adenocarcinoma | Authors: | Tseng, Jeng-Sen Yang, Tsung-Ying Tsai, Chi-Ren Chen, Kun-Chieh Hsu, Kuo-Hsuan Tsai, Meen-Hsin SUNG-LIANG YU KANG-YI SU Chen, Jeremy J. W. MONG-HSUN TSAI |
Issue Date: | 2015 | Journal Volume: | 10 | Journal Issue: | 4 | Start page/Pages: | 603-610 | Source: | Journal of Thoracic Oncology | Abstract: | Background: Epidermal growth factor receptor (EGFR) mutation status in lung cancer can effectively predict EGFR-tyrosine kinase inhibitor (TKI) efficacy. We evaluated the role of dynamic plasma cell-free DNA EGFR mutation status in outcome prediction. Methods: Advanced lung adenocarcinoma patients were enrolled and prospectively observed for outcomes of EGFR-TKI treatment. Peptide nucleic acid-zip nucleic acid polymerase chain reaction clamp method was developed to assess EGFR mutations in matched tumor and serial plasma cell-free DNA specimens. Results: A total of 72 patients were enrolled in this study, of which 62 patients (86.1%) had EGFR-mutant tumors (34 patients with exon 19 deletions, and 28 patients with L858R). Pretreatment plasma used for EGFR mutation testing showed a sensitivity of 59.7% and a specificity of 100%. Detection sensitivity was significantly higher in stage IV-M1b patients compared with stage IIIb and IV-M1a patients (78.0% versus 23.8%, p < 0.001). All patients who presented with EGFR-mutant tumors received first-line EGFR-TKI therapy. The objective response rate and disease control rate were 74.2% and 82.3%, respectively. Median progression-free survival and overall survival were 8.8 months (95% CI: 6.6-11.0) and 20.5 months (95% CI 15.1-26.0), respectively. Failure to clear plasma EGFR mutations after EGFR-TKI treatment was an independent predictor of lower disease control rate (odds ratio 5.26 [95% CI: 1.13-24.44]; p = 0.034), shorter progression-free survival (hazard ratio: 1.97 [95% CI: 1.33-2.91]; p = 0.001), and shorter overall survival (hazard ratio: 1.82 [95% CI: 1.04-3.18], p = 0.036). Conclusion: Changes in plasma EGFR mutation status can be successfully assessed using the peptide nucleic acid-zip nucleic acid polymerase chain reaction clamp method and can serve as an independent outcome predictor. ? 2015 by the International Association for the Study of Lung Cancer. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/507239 | ISSN: | 1556-0864 | DOI: | 10.1097/JTO.0000000000000443 | SDG/Keyword: | DNA; epidermal growth factor receptor; erlotinib; gefitinib; peptide nucleic acid; protein tyrosine kinase inhibitor; anilide; DNA; EGFR protein, human; EGFR tyrosine kinase inhibitor 324674; epidermal growth factor receptor; pyrimidine derivative; adult; aged; Article; cancer staging; cancer survival; cell free system; clamp; clinical trial; controlled study; disease control; drug efficacy; exon; female; gene mutation; human; lung adenocarcinoma; major clinical study; male; observational study; overall survival; polymerase chain reaction; prediction; priority journal; progression free survival; prospective study; sensitivity and specificity; treatment outcome; treatment response; adenocarcinoma; antagonists and inhibitors; blood; disease free survival; epidemiology; genetics; Lung Neoplasms; middle aged; mortality; mutation; nucleotide sequence; prognosis; survival rate; Taiwan; trends; very elderly; young adult; Adenocarcinoma; Adult; Aged; Aged, 80 and over; Anilides; Disease-Free Survival; DNA Mutational Analysis; DNA, Neoplasm; Female; Humans; Lung Neoplasms; Male; Middle Aged; Mutation; Neoplasm Staging; Prognosis; Prospective Studies; Pyrimidines; Receptor, Epidermal Growth Factor; Survival Rate; Taiwan; Young Adult |
Appears in Collections: | 醫學檢驗暨生物技術學系 |
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