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Clinical and Translational Medicine

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Open Access 01-12-2019 | NSCLC | Research

EGFR plasma mutation in prediction models for resistance with EGFR TKI and survival of non-small cell lung cancer

Authors: Thang Thanh Phan, Bich-Thu Tran, Son Truong Nguyen, Toan Trong Ho, Hang Thuy Nguyen, Vu Thuong Le, Anh Tuan Le

Published in: Clinical and Translational Medicine | Issue 1/2019

Abstract

Background

This study aims to clarify the prognostic role of epidermal growth factor receptor (EGFR) mutations in plasma of non-small cell lung cancer (NSCLC) for resistance to tyrosine kinase inhibitor (TKI), in correlation with clinical characteristics. A total of 94 Adenocarcinoma, clinical stage IV NSCLC patients with either E19del or L858R mutation were admitted to the prospective study from Jan-2016 to Jul-2018. EGFR mutations in plasma were detected by scorpions ARMS method. The Kaplan–Meier and Cox regression methods were used to estimate and test the difference of progression-free survival (PFS) and overall survival (OS) between groups. The prognostic power of each factor was appraised by the Bayesian Model Averaging (BMA) method.

Results

Among 94 patients, 28 cases still are good responses according to the RECIST criteria and negative for EGFR mutations in plasma. Of 66 resistant patients, EGFR mutations were positive in plasma of 57 cases (86.4%) which was higher than the value of pre-treatment (48.5%). Of which, 17 patients (25.8%) have the occurrence of EGFR mutations in plasma earlier than progression 2.1 (0.6–7.9) months. The secondary T790M mutation was found in the plasma of 32 cases (48.5%). Median PFS and OS for the study subjects were 12.9 (11.0–14.2) and 29.5 (25.2–41.3) months, respectively. The post-treatment EGFR plasma test with brain and new metastasis were detected as independent prognostic factors for worse PFS (P = 0.008, 0.016 and 0.028, respectively). While EGFR plasma (P = 0.044) with bone metastasis at baseline (P = 0.012), new metastasis (P = 0.003), and high cfDNA concentration (P = 0.004) serve as the worse survival factors, surgery treatment helps to prolong OS in NSCLC treated with EGFR TKI (P = 0.012). BMA analysis identified EGFR plasma test as the strongest prognostic factor for both PFS and OS (possibility of 100% and 99.7%, respectively).

Conclusions

EGFR plasma test is the powerfully prognostic factor for early resistance with EGFR TKI and worse survival in NSCLC regardless of clinical characteristics.

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Title: EGFR plasma mutation in prediction models for resistance with EGFR TKI and survival of non-small cell lung cancer
Authors: Thang Thanh Phan
Bich-Thu Tran
Son Truong Nguyen
Toan Trong Ho
Hang Thuy Nguyen
Vu Thuong Le
Anh Tuan Le
Publication date: 01-12-2019
Publisher: Springer Berlin Heidelberg
Keywords: NSCLC
Metastasis
Tyrosine Kinase Inhibitors
NSCLC
Bone Metastasis
Tyrosine Kinase Inhibitors
Published in: Clinical and Translational Medicine / Issue 1/2019
Electronic ISSN: 2001-1326
DOI: https://doi.org/10.1186/s40169-019-0219-8

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

EGFR plasma mutation in prediction models for resistance with EGFR TKI and survival of non-small cell lung cancer

Abstract

Background

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Results

Conclusions

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