Clinical correlations with EGFR circulating tumor DNA testing in all-stage lung adenocarcinoma
Issued Date
2023-01-01
Resource Type
ISSN
15740153
eISSN
18758592
Scopus ID
2-s2.0-85147045718
Pubmed ID
36530081
Journal Title
Cancer Biomarkers
Volume
36
Issue
1
Start Page
71
End Page
82
Rights Holder(s)
SCOPUS
Bibliographic Citation
Cancer Biomarkers Vol.36 No.1 (2023) , 71-82
Suggested Citation
Incharoen P., Jinawath A., Arsa L., Kamprerasart K., Trachu N., Monnamo N., Khiewngam K., Muntham D., Chansriwong P., Sirachainan E., Reungwetwattana T. Clinical correlations with EGFR circulating tumor DNA testing in all-stage lung adenocarcinoma. Cancer Biomarkers Vol.36 No.1 (2023) , 71-82. 82. doi:10.3233/CBM-220079 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/82330
Title
Clinical correlations with EGFR circulating tumor DNA testing in all-stage lung adenocarcinoma
Other Contributor(s)
Abstract
BACKGROUND: Information on genetic alterations, notably EGFR mutations, is important for guiding non-small-cell lung cancer (NSCLC) treatment. Circulating tumor DNA (ctDNA) analysis represents a less invasive alternative to tissue biopsy for analyzing mutation status, but its clinical value may vary across disease stages. OBJECTIVE: To explore clinical correlates of ctDNA and tissue/plasma-based EGFR mutation (EGFRm) status across all NSCLC stages. METHODS: Ninety patients were analyzed, representing three cohorts: newly-diagnosed early-stage, advanced-stage, and recurrent NSCLC. Relationships among clinical/surgical parameters, ctDNA, EGFRm status, and survival outcomes were analyzed. RESULTS: Plasma/tissue EGFRm concordance was lower in early-stage (58.6%) than in advanced-stage patients (87.5%). In early-stage patients, ctDNA levels were variable and not significantly associated with clinical/surgical parameters. In advanced-stage patients, time to EGFR-TKI treatment failure (TTF), but not overall survival (OS), was significantly longer in EGFRm-positive vs. EGFRm-negative patients. In patients with recurrent disease, 40% of plasma samples were EGFRT790M-positive at recurrence. In T790M-positive patients, we noted slight trends toward longer OS with vs. without osimertinib treatment and longer OS and TTF with second-line vs. later-line osimertinib. CONCLUSIONS: Our results affirm the use of ctDNA testing in advanced-stage and recurrent NSCLC. Further studies on osimertinib as early-line therapy, clinical correlates and the utility of plasma-based testing in early-stage NSCLC are warranted.