Prognostic value of plasma EGFR ctDNA in NSCLC patients treated with EGFR-TKIs.
OBJECTIVE
Epidermal growth factor receptor (EGFR) specific mutations have been known to improve survival of patients with non-small-cell lung carcinoma (NSCLC). However, whether there are any changes of EGFR mutations after targeted therapy and its clinical significance is unclear. This study was to identify the status of EGFR mutations after targeted therapy and predict the prognostic significance for NSCLC patients.


METHODS
A total of forty-five (45) NSCLC patients who received EGFR-TKI therapy were enrolled. We identified the changes of EGFR mutations in plasma ctDNA by Amplification Refractory Mutation System (ARMS) PCR technology.


RESULTS
In the 45 cases of NSCLC with EGFR mutations, the EGFR mutation status changed in 26 cases, in which, 12 cases (26.7%) from positive to negative, and 14 cases (31.1%) from T790M mutation negative to positive after TKI targeted therapy. The T790M occurance group had a shorter Progression -Free-Survival (PFS) than the groups of EGFR mutation undetected and EGFR mutation turned out to have no change after EGFR-TKI therapy (p < 0.05).


CONCLUSIONS
According to this study, it's necessary to closely monitor EGFR mutations during follow-up to predict the prognosis of NSCLC patients who are to receive the TKI targeted therapy.
Department of Molecular Pathology, Henan Cancer Hospital, The Affiliated Cancer Hospital, Zhengzhou University, Zhengzhou, China.
Chengjuan
C
Zhang
Department of Molecular Pathology, Henan Cancer Hospital, The Affiliated Cancer Hospital, Zhengzhou University, Zhengzhou, China.
Bing
B
Wei
Department of Infectious Diseases, Henan Provincial People's Hospital, Zhengzhou, China.
Peng
P
Li
Department of Molecular Pathology, Henan Cancer Hospital, The Affiliated Cancer Hospital, Zhengzhou University, Zhengzhou, China.
Ke
K
Yang
Department of Molecular Pathology, Henan Cancer Hospital, The Affiliated Cancer Hospital, Zhengzhou University, Zhengzhou, China.
Zhizhong
Z
Wang
Department of Molecular Pathology, Henan Cancer Hospital, The Affiliated Cancer Hospital, Zhengzhou University, Zhengzhou, China.
Jie
J
Ma
Department of Molecular Pathology, Henan Cancer Hospital, The Affiliated Cancer Hospital, Zhengzhou University, Zhengzhou, China.
Yongjun
Y
Guo
D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002289:Carcinoma, Non-Small-Cell Lung / Q000097:blood* / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D004273:DNA, Neoplasm / Q000097:blood*; D018572:Disease-Free Survival; D066246:ErbB Receptors / Q000235:genetics*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000097:blood* / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009154:Mutation / Q000235:genetics; D011379:Prognosis; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use; D011505:Protein-Tyrosine Kinases / Q000037:antagonists & inhibitors*
D000970:Antineoplastic Agents; D004273:DNA, Neoplasm; D047428:Protein Kinase Inhibitors; C512478:EGFR protein, human; D066246:ErbB Receptors; D011505:Protein-Tyrosine Kinases