Clinical Utility of Liquid Biopsy (Cell-free DNA) Based EGFR Mutation Detection Post treatment Initiation as a Disease Monitoring Tool in Patients With Advanced EGFR-mutant NSCLC

Behel, Vichitra; Choughule, Anuradha; Noronha, Vanita; Patil, Vijay; Menon, Nandini; Singh, Ajay Kumar; Kumar, Sunil; Kumar, Rajiv; Shah, Saleh; More, Sucheta; Banavali, Shripad; Chandrani, Pratik; Prabhash, Kumar

doi:10.1016/j.cllc.2022.04.002

Cited by 8 publications

(4 citation statements)

References 32 publications

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“…Mutation analysis of plasma ctDNA demonstrates the potential for disease monitoring in various cancers. EGFR mutation detection based on ctDNA is a monitoring tool for NSCLC patients, and EGFR mutation patients can serve as prognostic markers for first-line treatment (22). In this way, to solve the problem of not being able to obtain biomarkers promptly, next-generation sequencing technology (NGS) has become crucial.…”

Section: Discussionmentioning

confidence: 99%

Concordance of ctDNA and tissue mutations in NSCLC: A meta-analysis

Chengyuan Yu,

Yitong Han,

Mu Wang

et al. 2023

Cell Mol Biol (Noisy-le-grand)

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Section: Discussionmentioning

confidence: 99%

Concordance of ctDNA and tissue mutations in NSCLC: A meta-analysis

Chengyuan Yu,

Yitong Han,

Mu Wang

et al. 2023

Cell Mol Biol (Noisy-le-grand)

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“…Accurate molecular typing is the basis of this precise treatment; however, qualified tumor tissue specimens cannot be obtained from every patient, so liquid biopsy was developed. Many studies have prospectively verified the high specificity (92–100%) and positive predictive value (94.0–98.6%) of ctDNA-based EGFR mutation detection using tissues as a reference [ 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 ], and these two metrics have also been consistent in guiding the targeted therapy of NSCLC [ 30 , 31 , 34 , 35 ]. Recently, research on ctDNA-based next-generation sequencing (NGS) has demonstrated potential clinical utility [ 36 , 37 , 38 , 39 ].…”

Section: Plasma Ctdna-based Egfr Mutations Can Guide Targeted Therapy...mentioning

confidence: 99%

“…Table 1 presents data on the association between plasma ctDNA/cfDNA EGFR mutations and the efficacy and prognosis of targeted therapy in NSCLC patients [ 28 , 30 , 31 , 32 , 33 , 34 , 35 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 ]. The BENEFIT trial prospectively demonstrated the feasibility of using liquid biopsy to guide the efficacy of first-line EGFR-TKI therapy for the first time.…”

Section: Plasma Ctdna-based Egfr Mutations Can Guide Targeted Therapy...mentioning

confidence: 99%

Can Liquid Biopsy Based on ctDNA/cfDNA Replace Tissue Biopsy for the Precision Treatment of EGFR-Mutated NSCLC?

Kong

Liu

et al. 2023

JCM

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More and more clinical trials have explored the role of liquid biopsy in the diagnosis and treatment of EGFR-mutated NSCLC. In certain circumstances, liquid biopsy has unique advantages and offers a new way to detect therapeutic targets, analyze drug resistance mechanisms in advanced patients, and monitor MRD in patients with operable NSCLC. Although its potential cannot be ignored, more evidence is needed to support the transition from the research stage to clinical application. We reviewed the latest progress in research on the efficacy and resistance mechanisms of targeted therapy for advanced NSCLC patients with plasma ctDNA EGFR mutation and the evaluation of MRD based on ctDNA detection in perioperative and follow-up monitoring.

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“…Furthermore, the biopsied or surgical section tissue cannot fully reflect the spatial heterogeneity and temporal heterogeneity of the tumor. Liquid biopsy is non-invasive and convenient but its stability and false-negative rate are not satisfying ( 6 ). Therefore, there is an urgent need for a non-invasive and accurate method to determine EGFR mutation status and subtypes, so as to facilitate accurate screening of patients suitable for EGFR TKIs targeted therapy and make better treatment decisions in clinical practice.…”

Section: Introductionmentioning

confidence: 99%

Optimal 18F-FDG PET/CT radiomics model development for predicting EGFR mutation status and prognosis in lung adenocarcinoma: a multicentric study

Zuo

Liu

et al. 2023

Front. Oncol.

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PurposeTo develop and interpret optimal predictive models to identify epidermal growth factor receptor (EGFR) mutation status and subtypes in patients with lung adenocarcinoma based on multicentric 18F-FDG PET/CT data, and further construct a prognostic model to predict their clinical outcome.MethodsThe 18F-FDG PET/CT imaging and clinical characters of 767 patients with lung adenocarcinoma from 4 cohorts were collected. Seventy-six radiomics candidates using cross-combination method to identity EGFR mutation status and subtypes were built. Further, Shapley additive explanations and local interpretable model-agnostic explanations were used for optimal models’ interpretation. Moreover, in order to predict the overall survival, a multivariate Cox proportional hazard model based on handcrafted radiomics features and clinical characteristics was constructed. The predictive performance and clinical net benefit of the models were evaluated via area under receiver operating characteristic (AUC), C-index and decision curve analysis. ResultsAmong the 76 radiomics candidates, light gradient boosting machine classifier (LGBM) combined with recursive feature elimination wrapped LGBM feature selection method achieved best performance in predicting EGFR mutation status (AUC reached 0.80, 0.61, 0.71 in the internal test cohort and two external test cohorts, respectively). And extreme gradient boosting classifier combined with support vector machine feature selection method achieved best performance in predicting EGFR subtypes (AUC reached 0.76, 0.63, 0.61 in the internal test cohort and two external test cohorts, respectively). The C-index of the Cox proportional hazard model achieved 0.863.ConclusionsThe integration of cross-combination method and the external validation from multi-center data achieved a good prediction and generalization performance in predicting EGFR mutation status and its subtypes. The combination of handcrafted radiomics features and clinical factors achieved good performance in predicting prognosis. With the urgent needs of multicentric 18F-FDG PET/CT trails, robust and explainable radiomics models have great potential in decision making and prognosis prediction of lung adenocarcinoma.

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Clinical Utility of Liquid Biopsy (Cell-free DNA) Based EGFR Mutation Detection Post treatment Initiation as a Disease Monitoring Tool in Patients With Advanced EGFR-mutant NSCLC

Cited by 8 publications

References 32 publications

Concordance of ctDNA and tissue mutations in NSCLC: A meta-analysis

Concordance of ctDNA and tissue mutations in NSCLC: A meta-analysis

Can Liquid Biopsy Based on ctDNA/cfDNA Replace Tissue Biopsy for the Precision Treatment of EGFR-Mutated NSCLC?

Optimal 18F-FDG PET/CT radiomics model development for predicting EGFR mutation status and prognosis in lung adenocarcinoma: a multicentric study

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