Treatment of advanced non-small-cell lung cancer

Prabhash, Kumar; Vora, Amish; Limaye, Sewanti; Sahoo, Tapan Kumar; Batra, Ullas; Patil, Shekhar; Patil, Vijay; Noronha, Vanita; Bhosale, Bharat; Raut, Nirmal Vivek; Warrier, Narayanankutty; Vaswani, Bharat; Babu, Govind; Gore, Adwaita; Rohatgi, Nitesh; Bondarde, Shailesh Arjun

doi:10.4103/crst.crst_61_21

Cited by 43 publications

(8 citation statements)

References 226 publications

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“…Invalid results were obtained in 6% ( n = 9) of the samples. From the valid results, 42% ( n = 61) of the samples were reported as EGFR mutant 17,18 viz Ex19 deletions in 54.10% ( n = 33), L858R in 27.87% ( n = 17), L861Q in 3.28% ( n = 2) and T790M in 1.64% ( n = 1). Microfluidic mutation detection platform could also effectively detect rare concomitant mutations such as Exon 19 deletion+T790M ( n = 2, 3.28%), Exon 19 deletions+S768I ( n = 1, 1.64%), G719X + S768I ( n = 1, 1.64%), L858R + T790M ( n = 2, 3.28%) mutation from the clinical samples.…”

Section: Resultsmentioning

confidence: 99%

Microfluidics‐based EGFR mutation detection and its implication in the resource‐limited clinical setting

Joshi,

Gogte,

Pai

et al. 2024

Int J Experimental Path

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Management of lung cancer today obligates a mutational analysis of the epidermal growth factor receptor (EGFR) gene particularly when Tyrosine Kinase Inhibitor (TKI) therapy is being considered as part of prognostic stratification. This study evaluates the performance of automated microfluidics‐based EGFR mutation detection and its significance in clinical diagnostic settings. Formalin‐fixed, paraffin‐embedded (FFPE) samples from NSCLC patients (n = 174) were included in a two‐phase study. Phase I: Validation of the platform by comparing the results with conventional real‐time PCR and next‐generation sequencing (NGS) platform. Phase II: EGFR mutation detection on microfluidics‐based platform as part of routine diagnostics workup. The microfluidics‐based platform demonstrates 96.5% and 89.2% concordance with conventional real‐time PCR and NGS, respectively. The system efficiently detects mutations across the EGFR gene with 88.23% sensitivity and 100% specificity. Out of 144 samples analysed in phase II, the platform generated valid results in 94% with mutation detected in 41% of samples. This microfluidics‐based platform can detect as low as 5% mutant allele fractions from the FFPE samples. Therefore the microfluidics‐based platform is a rapid, complete walkaway, with minimum tissue requirement (two sections of 5 μ thickness) and technical skill requirement. The method can detect clinically actionable EGFR mutations efficiently and can be considered a reliable diagnostic platform in resource‐limited settings. From receiving samples to reporting the results this platform provides accurate data without much manual intervention. The study helped to devise an algorithm that emphasizes effective screening of the NSCLC cases for EGFR mutations with varying tumour content. Thus it helps in triaging the cases judiciously before proceeding with multigene testing.

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Section: Resultsmentioning

confidence: 99%

Microfluidics‐based EGFR mutation detection and its implication in the resource‐limited clinical setting

Joshi,

Gogte,

Pai

et al. 2024

Int J Experimental Path

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“…The advent of new targeted agents and ICIs has changed the treatment paradigm in NSCLC. 1 EGFR TKIs are no longer considered appropriate therapy for patients with wild-type EGFR and have been removed as an option from international treatment guidelines. This may make it this study seems irrelevant now, but even today, there is no standard-of-care third-line systemic therapy for driver mutation-negative NSCLC, and few studies have specifically addressed this question.…”

Section: Discussionmentioning

confidence: 99%

“…The treatment paradigm of lung cancer has changed with the availability of very effective first-line systemic therapy. 1 The use of immunotherapy, identification of molecular drivers and effective targeted therapy, and better supportive care have significantly improved outcomes in patients with advanced NSCLC. This has increased the number of patients who receive treatment in the third line and beyond setting.…”

Section: Introductionmentioning

confidence: 99%

A Comparative Study Evaluating the Quality of Life and Survival Outcomes in Patients Receiving Chemotherapy Versus Oral Tyrosine Kinase Inhibitor in the Third Line and Beyond Setting for Advanced NSCLC

Noronha,

Menon,

Patil

et al. 2024

JTO Clinical and Research Reports

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“…Non-small cell lung cancer (NSCLC) is the most common type of lung cancer constituting around 85% of all lung cancers [ 7 ]. It is a debilitating subtype of lung cancer and is the prominent cause of death associated with cancer [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Consensus Recommendations for the Diagnosis, Biomarker Testing, and Clinical Management of Advanced or Metastatic Non-small Cell Lung Cancer With Mesenchymal-Epithelial Transition Exon 14 Skipping Mutations in the Middle East, Africa, and Russia

Mahrous¹,

Jebriel²,

Allehebi³

et al. 2023

Cureus

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Mesenchymal-epithelial transition exon 14 (METex14) skipping mutations occur in about 3%-4% of patients with non-small cell lung cancer (NSCLC). This is an aggressive subtype associated with poor prognosis. METex14 skipping is a potentially targetable mutation. Targeted therapy is a promising treatment modality for patients with advanced/metastatic METex14-mutant NSCLC. Performing systematic molecular testing to detect the driver mutation is essential for initiating targeted therapy. However, there is a lack of guidelines on molecular testing for assessing the eligibility of patients for targeted therapy. Therefore, a multidisciplinary panel consisting of experts from the Middle East, Africa, and Russia convened via a virtual advisory board meeting to provide their insights on various molecular testing techniques for the diagnosis of METex14 skipping mutation, management of patients with targeted therapies, and developing consensus recommendations for improving the processes. The expert panel emphasized performing molecular testing and liquid biopsy before treatment initiation and tissue re-biopsy for patients with failed molecular testing. Liquid biopsy was recommended as complementary to tissue biopsy for disease monitoring and prognosis. Selective MET inhibitors were recommended as the first and subsequent lines of therapy. These consensus recommendations will facilitate the management of METex14 skipping NSCLC in routine practice and warrant optimum outcomes for these patients.

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Treatment of advanced non-small-cell lung cancer

Cited by 43 publications

References 226 publications

Microfluidics‐based EGFR mutation detection and its implication in the resource‐limited clinical setting

Microfluidics‐based EGFR mutation detection and its implication in the resource‐limited clinical setting

A Comparative Study Evaluating the Quality of Life and Survival Outcomes in Patients Receiving Chemotherapy Versus Oral Tyrosine Kinase Inhibitor in the Third Line and Beyond Setting for Advanced NSCLC

Consensus Recommendations for the Diagnosis, Biomarker Testing, and Clinical Management of Advanced or Metastatic Non-small Cell Lung Cancer With Mesenchymal-Epithelial Transition Exon 14 Skipping Mutations in the Middle East, Africa, and Russia

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