Provisional Guideline Recommendation for EGFR Gene Mutation Testing in Liquid Samples of Lung Cancer Patients: A Proposal by the Korean Cardiopulmonary Pathology Study Group

Abstract

Liquidbiopsy for detection ofmutationfrom circulating tumor DNA is a new technology which is attractive in that it is non-invasive. Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKI) is an effective first line drug for advanced non-small celllungcancerpatientswho harbor activatingEGFRmutation. During the course of treatment, resistance against TKI arises which can be contributed toEGFRT790Mmutationin about 50-60% ofpatients. Third generation TKI may overcome the resistance. Inpatientswho cannot undergo tissue biopsy due to variable reasons,liquidbiopsy is an excellent alternative for the detection ofEGFRT790Mmutation. However, this relatively novel method requires standardization and vigorous quality insurance. Thus, a standard set ofguidelinerecommendations forliquidbiopsy forEGFRmutationtestingsuitable for theKoreanmedical community is necessary. In this article, we propose a set ofprovisionalguidelinerecommendations that was discussed and approved by theCardiopulmonaryPathologyStudyGroupof theKoreanSociety of Pathologists.