Clinical Factors Predicting Detection of T790M Mutation in Rebiopsy for EGFR-Mutant Non–small-cell Lung Cancer

Kawamura, Takahisa; Kenmotsu, Hirotsugu; Omori, Shota; Nakashima, Kazuhisa; Wakuda, Kazushige; Ono, Akira; Naito, Tateaki; Murakami, Haruyasu; Omae, Katsuhiro; Mori, Keita; Tanigawara, Yusuke; Nakajima, Takashi; Ohde, Yasuhisa; Endo, Masahiro; Takahashi, Toshiaki

doi:10.1016/j.cllc.2017.07.002

Cited by 47 publications

(48 citation statements)

References 22 publications

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“…Evidence about clinical features of patients with EGFR mutations potentially predicting the acquisition of T790M mutation is currently limited and mostly available on Asian patients. [31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50] This clinical scenario would hopefully help to select the right strategy for every patient, considering the availability of a thirdgeneration TKI both as a firstand second-line treatment option.…”

Section: Discussionmentioning

confidence: 99%

“…To date, mostly retrospective [31][32][33][34][35][36][37][38][39][40][41][42][43][44][45] and 2 prospective 46,47 Asian case series investigated clinical-pathologic characteristics of T790M mutant lung cancer. Only a few data are available in Caucasian patients, and none of these studies investigated clinical progression patterns related to T790M in detail.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Features and Progression Pattern of Acquired T790M-positive Compared With T790M-negative EGFR Mutant Non–small-cell Lung Cancer: Catching Tumor and Clinical Heterogeneity Over Time Through Liquid Biopsy

Maso

Roca

Pilotto

et al. 2020

Clinical Lung Cancer

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Clinical Features and Progression Pattern of Acquired T790M-positive Compared With T790M-negative EGFR Mutant Non–small-cell Lung Cancer: Catching Tumor and Clinical Heterogeneity Over Time Through Liquid Biopsy

Maso

Roca

Pilotto

et al. 2020

Clinical Lung Cancer

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“…), which is consistent with several previous reports (Kuiper et al ., ; Matsuo et al ., ; Wang et al ., , ). The difference of PFS1 might be due to the complexed underlying resistance mechanisms: On one hand, T790M‐positive cells are selected and undergo enrichment after long‐term exposure to TKIs (Kawamura et al ., ; Wang et al ., , ), while on the other hand, the non‐T790M patients harbored some resistance mechanisms, such as KRAS mutation and/or unknown mechanisms, which may contribute to a worse TKI response compared with T790M.…”

Section: Discussionmentioning

confidence: 99%

Combined plasma and tissue genotyping of EGFR T790M benefits NSCLC patients: a real‐world clinical example

Wei

Zhao

et al. 2019

Molecular Oncology

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Acquired resistance to epidermal growth factor receptor ( EGFR )‐tyrosine kinase inhibitors ( TKI s) is a prevalent clinical problem in the management of advanced non‐small‐cell lung cancer ( NSCLC ) with TKI ‐sensitizing mutations in the EGFR gene. Third‐generation EGFR ‐ TKI s have demonstrated potent activity against TKI resistance mediated by the EGFR T790M mutation, and standard rebiopsy and liquid biopsy are utilized to assess the T790M status of the NSCLC patients who experienced progressive disease (PD). Here, we conducted a retrospective study to assess 375 patients whose initial biopsy indicated a TKI ‐sensitizing mutation (either EGFR 19del or L858R) and who developed PD after treatment with first‐generation TKI s, and assayed for T790M status. We adopted a combination approach in which tissue rebiopsy is preferred, utilizing liquid biopsies when tissue rebiopsy is not feasible. We analyzed the potential predictive clinical factors affecting T790M detection, evaluated the standard rebiopsy and liquid biopsy methods in T790M genotyping, and reported the clinical performance of osimertinib. Our results suggested that primary EGFR 19del, brain metastasis, and longer progression‐free survival of initial EGFR ‐ TKI treatment are associated with acquired T790M resistance. T790M‐positive patients significantly benefited from osimertinib. In conclusion, the real‐world clinical adoption of the combination approach with both tissue rebiopsy and liquid biopsy for T790M genotyping may provide significant benefits to patients who have developed PD after first‐generation TKI treatments.

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“…15 In addition, a previous study revealed that long periods of EGFR-TKI treatment before rebiopsy may provide useful information regarding expression of the T790M mutation. 16 Therefore, our results also provide useful data for treating patients who experience AEs during EGFR-TKI treatment.…”

Section: Discussionmentioning

confidence: 65%

“…Approximately 60% of patients with EGFR mutations have the T790M mutation when they experience PD during the first EGFR‐TKI treatment, and sequential treatment using a third‐generation EGFR‐TKI is critical for these patients . In addition, a previous study revealed that long periods of EGFR‐TKI treatment before rebiopsy may provide useful information regarding expression of the T790M mutation . Therefore, our results also provide useful data for treating patients who experience AEs during EGFR‐TKI treatment.…”

Section: Discussionmentioning

confidence: 66%

The effects of switching EGFR‐TKI treatments for non‐small cell lung cancer because of adverse events

Sakata

Kawamura

Shingu

et al. 2018

Asia-Pac J Clncl Oncology

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Background Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR‐TKIs) are used to treat patients with non‐small cell lung cancer (NSCLC) and EGFR driver mutations. Although some patients discontinued these treatments because of adverse events, it is unclear whether switching EGFR‐TKI because of adverse events provides a benefit. Methods This retrospective study evaluated data from 22 patients with EGFR mutation‐positive NSCLC who received at least two EGFR‐TKIs that were switched because of adverse events (March 2011 to September 2017). Progression‐free survival 2 (PFS2) was defined as the time from starting of the first EGFR‐TKI treatment to disease progression during the second EGFR‐TKI treatment. Results Seventeen patients received gefitinib as the first EGFR‐TKI treatment, while four patients received afatinib and one patient received erlotinib. The median time to failure of the first EGFR‐TKI treatment was 1.6 months. The EGFR‐TKIs were switched because of hepatotoxicity (n = 16), interstitial lung disease (n = 3), and other reasons (n = 3). The median washout period was 1.1 months. Seventeen patients received erlotinib as the second EGFR‐TKI treatment, while three patients received gefitinib and two patients received afatinib. The median PFS for the second EGFR‐TKI treatment was 15.2 months. The median PFS2 was 17.7 months and the median overall survival was 32.8 months. Conclusions Switching EGFR‐TKIs because of adverse events provided a clinical benefit for patients with EGFR mutation‐positive NSCLC. Appropriate judgment regarding switching from one EGFR‐TKI to another may improve the performance status and prognosis of patients with EGFR mutation‐positive NSCLC.

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Clinical Factors Predicting Detection of T790M Mutation in Rebiopsy for EGFR-Mutant Non–small-cell Lung Cancer

Cited by 47 publications

References 22 publications

Clinical Features and Progression Pattern of Acquired T790M-positive Compared With T790M-negative EGFR Mutant Non–small-cell Lung Cancer: Catching Tumor and Clinical Heterogeneity Over Time Through Liquid Biopsy

Clinical Features and Progression Pattern of Acquired T790M-positive Compared With T790M-negative EGFR Mutant Non–small-cell Lung Cancer: Catching Tumor and Clinical Heterogeneity Over Time Through Liquid Biopsy

Combined plasma and tissue genotyping of EGFR T790M benefits NSCLC patients: a real‐world clinical example

The effects of switching EGFR‐TKI treatments for non‐small cell lung cancer because of adverse events

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