University of California San Francisco, Fresno, CA
Copyright 2016, American College of Chest Physicians. All Rights Reserved.
SESSION TITLE: Lung Cancer III
SESSION TYPE: Original Investigation Poster
PRESENTED ON: Wednesday, October 26, 2016 at 01:30 PM - 02:30 PM
PURPOSE: Lung Cancer continues to be the leading cause of cancer related mortality worldwide. Recent technological advances can detect ubiquitous and heterogeneous tumor mutation variants in blood samples from patients with lung cancer. However, qualitative validation is necessary in order to implement utility of such tests in clinical practice. In this study, we hypothesize that tumor derived circulating DNA can be used to detect tumor specific mutation in non-small cell lung cancer (NSCLC).
METHODS: Patients with newly diagnosed histological proven NSCLC were enrolled in the study using IRB approved protocol. Comparative mutation analyses of biopsy samples to that of serum were performed by next generation sequencing. The study was focused on common targetable EGFR and KRAS mutations. Considering that the mutations in tumor biopsies are the current gold standard, tumor tissue mutation profile was utilized for comparative analysis using Pearson’s χ2 test.
RESULTS: We identified 27 patients with biopsy proven NSCLC with paired tumor tissue and blood mutation analysis. Detection of EGFR Exon 21 L858R in the blood was found to have sensitivity of 66% and specificity of 100%. Detection of Exon 20 T790M was found to be in the blood of one patient with undetectable T790M tissue mutation; while, none of our patients has any detectable Exon 19 DEL mutation. Analysis of KRAS G12C in the blood had sensitivity of 100% and specificity of 100%. KRAS G12V had sensitivity 100% with specificity 95%. These findings suggest a tremendous potential of utility of liquid biopsy in clinical practice. Further large scale studies are required to validate these findings.
CONCLUSIONS: Noninvasive liquid biopsy technology is useful for identification of tumor specific mutations in NSCLC.
CLINICAL IMPLICATIONS: Rapid detection of targetable tumor specific mutation in the blood may facilitate personalized treatment selection in individual patients with lung cancer.
DISCLOSURE: The following authors have nothing to disclose: Prathamesh Prabhudesai, Valentine Ifeacho, Mickey Sachdeva, Pravachan Pravachan, Viola Zhu, Michael Peterson, Daya Upadhyay
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