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Presence of mEGFR ctDNA predicts a poor clinical outcome in lung adenocarcinoma

Authors
 Taehee Kim  ;  Eun Young Kim  ;  Sang Hoon Lee  ;  Do Sun Kwon  ;  Arum Kim  ;  Yoon Soo Chang 
Citation
 THORACIC CANCER, Vol.10(12) : 2267-2273, 2019 
Journal Title
 THORACIC CANCER 
ISSN
 1759-7706 
Issue Date
2019
Keywords
ctDNA ; ddPCR ; lung adenocarcinoma ; mEGFR
Abstract
BACKGROUND: Circulating tumor DNA (ctDNA) is a biomarker for the selection of target agents in various malignancies. In this study, we examined the effect of ctDNA presence on the response to EGFR-tyrosine kinase inhibitor (TKI) and on the prognosis in lung adenocarcinoma. METHODS: ctDNA of EGFR-TKI sensitizing mutations (mEGFR), L858R substitution and Exon 19 deletion (E19d) mutation, was evaluated using droplet digital PCR (ddPCR) in 81 patients with lung adenocarcinoma which harbored mEGFR in the corresponding tumor tissues. RESULTS: The study recruited lung cancer patients at various stages, and the sensitivity, specificity, and area under the curve (AUC) of mEGFR ctDNA detection by ddPCR were 40.0%, 88.5%, and 0.68, respectively. It showed higher sensitivity (75.0% vs. 10.0%) and AUC (0.83 vs. 0.49) in the advanced stages of lung adenocarcinoma compared with the early stages and the number of metastases and the fractional abundance of mEGFR ctDNA showed a strong correlation (σ = 0.516; P < 0.001, Spearman correlation test). There was a significantly shorter progression-free survival and duration of disease control by EGFR-TKIs in the ctDNA-positive group than the negative group (14.0 vs. 41.0 months, P = 0.02 and 12.0 vs. 23.0 months, P = 0.02, log-rank test, respectively). There was a trend for overall survival time to be shorter in patients with mEGFR ctDNA than for patients without mEGFR ctDNA (35.6 vs. 67.1 months, P = 0.06, log-rank test). CONCLUSIONS: These data showed that mEGFR ctDNA detection using ddPCR is useful in the advanced stages and its presence predicted distant metastasis and poor clinical outcome in lung adenocarcinoma.
Files in This Item:
T201905081.pdf Download
DOI
10.1111/1759-7714.13219
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
Kwon, Do Sun(권도선)
Kim, Arum(김아름)
Kim, Eun Young(김은영) ORCID logo https://orcid.org/0000-0002-3281-5744
Lee, Sang Hoon(이상훈) ORCID logo https://orcid.org/0000-0002-7706-5318
Chang, Yoon Soo(장윤수) ORCID logo https://orcid.org/0000-0003-3340-4223
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/174625
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