The increase in activating EGFR mutation in plasma is an early biomarker to monitor response to osimertinib: a case report.
BMC Cancer
; 19(1): 410, 2019 Apr 30.
Article
em En
| MEDLINE
| ID: mdl-31039766
ABSTRACT
BACKGROUND:
Systemic treatment of advanced non-small cell lung cancer (NSCLC) has changed dramatically since the introduction of targeted therapies. The analysis of circulating tumor DNA (ctDNA) is a valuable approach to monitor the clonal evolution of tumors during treatment with EGFR-tyrosine kinase inhibitors (TKIs) and to detect resistance mutations. CASE PRESENTATION A NSCLC patient with exon 19 deletion (ex19del) of EGFR was treated with osimertinib after multiple lines of treatment and obtained a partial response that lasted over 26 months. Blood was collected at each visit and ctDNA was extracted to monitor ex19del by digital droplet PCR. Within a few weeks from the beginning of osimertinib, ex19del disappeared from plasma but appeared again and steadily increased a few months later anticipating tumor progression. Interestingly, the change in ex19del was much more pronounced than other mutations, since T790M appeared 3 months after the increase of ex19del, and C797S was detectable a few weeks before clinical disease progression. Then the patient received cytotoxic chemotherapy, which was associated with a decrease in ex19del and disappearance of T790M and C797S; however, at disease progression, all EGFR mutations increased again in plasma together with MET amplification which was detected by NGS.CONCLUSIONS:
The measurement of ex19del changes in ctDNA is a simple and sensitive approach to monitor clinical outcome to osimertinib and, potentially, to other therapeutic interventions.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Acrilamidas
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Deleção de Sequência
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Carcinoma Pulmonar de Células não Pequenas
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Compostos de Anilina
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Neoplasias Pulmonares
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article