A Real-World, Observational, Prospective Study to Assess the Molecular Epidemiology of Epidermal Growth Factor Receptor (EGFR) Mutations upon Progression on or after First-Line Therapy with a First- or Second-Generation EGFR Tyrosine Kinase Inhibitor in EGFR Mutation-Positive Locally Advanced or Metastatic Non-Small Cell Lung Cancer: The 'LUNGFUL' Study.
Giannis S MountziosAnna KoumarianouAlexandros BokasDimitrios MavroudisEpaminondas SamantasEvangelos Georgios FergadisHelena LinardouPanagiotis KatsaounisElias AthanasiadisMichalis V KaramouzisGeorge PentheroudakisSofia LampakiMarios E FroudarakisEleni-Isidora A PerdikouriAlvertos SomarakisFoteini PapageorgiouZoe PaparepaAristeidis NikolaouKonstantinos N SyrigosPublished in: Cancers (2021)
Background: Real-world data on the molecular epidemiology of EGFR resistance mutations at or after progression with first- or second-generation EGFR-TKIs in patients with advanced NSCLC are lacking. Methods: This ongoing observational study was carried out by 23 hospital-based physicians in Greece. The decision to perform cobas®EGFR Mutation Test v2 in tissue and/or plasma at disease progression was made before enrollment. For patients with negative/inconclusive T790M plasma-based results, tissue re-biopsy could be performed. Results: Ninety-six (96) eligible patients were consecutively enrolled (median age: 67.8 years) between July-2017 and September-2019. Of the patients, 98% were tested upon progression using plasma and 2% using tissue/cytology biopsy. The T790M mutation was detected in 16.0% of liquid biopsies. Tissue re-biopsy was performed in 22.8% of patients with a T790M-negative plasma result. In total, the T790M positivity rate was 21.9%, not differing between patients on first- or second-generation EGFR-TKI. Higher (≥2) ECOG performance status and longer (≥10 months) time to disease progression following EGFR-TKI treatment initiation were associated with T790M positivity. Conclusions: Results from plasma/tissue-cytology samples in a real-world setting, yielded a T790M positivity rate lower than previous reports. Fewer than one in four patients with negative plasma-based testing underwent tissue re-biopsy, indicating the challenges in routine care settings.
Keyphrases
- epidermal growth factor receptor
- small cell lung cancer
- tyrosine kinase
- advanced non small cell lung cancer
- end stage renal disease
- ultrasound guided
- fine needle aspiration
- newly diagnosed
- ejection fraction
- primary care
- chronic kidney disease
- stem cells
- healthcare
- prognostic factors
- radiation therapy
- locally advanced
- patient reported outcomes
- machine learning
- chronic pain
- mesenchymal stem cells
- cross sectional
- emergency department
- brain metastases
- pain management
- deep learning
- decision making