domingo, 5 de enero de 2020

Clinical feasibility of NGS liquid biopsy analysis in NSCLC patients. - PubMed - NCBI

2019 Dec 20;14(12):e0226853. doi: 10.1371/journal.pone.0226853. eCollection 2019.

Clinical feasibility of NGS liquid biopsy analysis in NSCLC patients.

Papadopoulou E1, Tsoulos N1, Tsantikidi K1, Metaxa-Mariatou V1, Stamou PE1, Kladi-Skandali A1, Kapeni E1, Tsaousis G1, Pentheroudakis G2,3, Petrakis D2,3, Lampropoulou DI4, Aravantinos G4, Varthalitis I5, Kesisis G6, Boukovinas I7, Papakotoulas P8, Katirtzoglou N9, Athanasiadis E10, Stavridi F11, Christodoulou C12, Koumarianou A13, Eralp Y14, Nasioulas G1.

Author information

1: GeneKor MSA, Athens, Greece.
2: Department of Medical Oncology, School of Medicine, Ioannina, Greece.
3: Society for Study of Clonal Heterogeneity of Neoplasia (EMEKEN), Ioannina, Greece.
4: Second Department of Medical Oncology, Agii Anargiri Cancer Hospital, Athens, Greece.
5: 1st Oncology Department Henry Dunant Hospital Center, Athens, Greece.
6: Oncology Department, Saint Luke Private Hospital, Thessaloniki, Greece.
7: BioClinic Thessaloniki, Thessaloniki, Greece.
8: First Department of Clinical Oncology, Theagenio Hospital, Thessaloniki, Greece.
9: Euroclinic, Athens, Greece.
10: Department of Medical Oncology, Mitera Hospital, Athens, Greece.
11: Fourth Department of Medical Oncology, Hygeia Hospital, Athens, Greece.
12: Second Department of Medical Oncology, Metropolitan Hospital, Athens, Greece.
13: Hematology Oncology Unit, Fourth Department of Internal Medicine, Attikon University Hospital, Athens, Greece.
14: Department of Medical Oncology, Istanbul University School of Medicine, İstanbul, Turkey.

Abstract

BACKGROUND:

Analysis of circulating tumor nucleic acids in plasma of Non-Small Cell Lung Cancer (NSCLC) patients is the most widespread and documented form of "liquid biopsy" and provides real-time information on the molecular profile of the tumor without an invasive tissue biopsy.

METHODS:

Liquid biopsy analysis was requested by the referral physician in 121 NSCLC patients at diagnosis and was performed using a sensitive Next Generation Sequencing assay. Additionally, a comparative analysis of NSCLC patients at relapse following EGFR Tyrosine Kinase Inhibitor (TKIs) treatment was performed in 50 patients by both the cobas and NGS platforms.

RESULTS:

At least one mutation was identified in almost 49% of the cases by the NGS approach in NSCLC patients analyzed at diagnosis. In 36 cases with paired tissue available a high concordance of 86.11% was observed for clinically relevant mutations, with a Positive Predictive Value (PPV) of 88.89%. Furthermore, a concordance rate of 82% between cobas and the NGS approach for the EGFR sensitizing mutations (in exons 18, 19, 21) was observed in patients with acquired resistance to EGFR TKIs, while this concordance was 94% for the p.T790M mutation, with NGS being able to detect this mutation in three 3 additional patients.

CONCLUSIONS:

This study indicates the feasibility of circulating tumor nucleic acids (ctNA) analysis as a tumor biopsy surrogate in clinical practice for NSCLC personalized treatment decision making. The use of new sensitive NGS techniques can reliably detect tumor-derived mutations in liquid biopsy and provide clinically relevant information both before and after targeted treatment in patients with NSCLC. Thus, it could aid physicians in treatment decision making in clinical practice.