2022 World Conference on Lung Cancer (ePosters)-EP08.02-072. The Predictive Value of Longitudinal Monitoring of Mutated EGFR in Plasma of Advanced NSCLC Patients on First-Line EGFR-TKIs

EP08.02-072. The Predictive Value of Longitudinal Monitoring of Mutated EGFR in Plasma of Advanced NSCLC Patients on First-Line EGFR-TKIs

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This study aimed to assess the predictive value of monitoring mutated EGFR in plasma during first-line EGFR-TKI treatment in patients with advanced non-small cell lung cancer (NSCLC). Liquid biopsy, or the analysis of cell-free DNA in plasma, was used to detect activating and resistance EGFR mutations in these patients. The longitudinal analysis of circulating tumor-originated mutated EGFR (ctDNA) was found to be beneficial for real-time treatment monitoring and early detection of resistance mutations. <br /><br />The study included 80 NSCLC patients who were treated with afatinib, gefitinib, or erlotinib. The patients' demographic and clinical characteristics were recorded, and liquid biopsies were taken every 4 weeks up until 3 months after progression. The levels of mutated EGFR ctDNA in plasma were quantitatively assessed using the Cobas IVD test. <br /><br />The patients were divided into three groups based on the levels of mutated EGFR ctDNA in plasma: clearers (complete clearance of mutated EGFR after 1st month of treatment), non-clearers (elevated levels of mutated EGFR after 1st month of treatment), and non-shedders (no detectable mutated EGFR in plasma). <br /><br />Significant differences were observed in progression-free survival (PFS) between the clearers, non-clearers, and non-shedders. Clearers had a longer median PFS compared to non-clearers and non-shedders. No significant differences were found between patients with different types of EGFR mutations. <br /><br />The study concluded that the longitudinal monitoring of mutated EGFR in plasma using the Cobas test showed predictive value for treatment outcomes in NSCLC patients on first-line EGFR-TKIs. The complete clearance of mutated EGFR within the initial months of treatment may predict a longer duration of EGFR-TKIs. The Cobas test was found to provide reliable results on the EGFR mutation status and level in plasma. This study was funded by AstraZeneca.

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Joanna Chorostowska-Wynimko

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Speaker Joanna Chorostowska-Wynimko

Topic Metastatic Non-small Cell Lung Cancer - Molecular Targeted Treatments

Keywords

predictive value

monitoring

mutated EGFR

plasma

first-line EGFR-TKI treatment

advanced non-small cell lung cancer

liquid biopsy

activating mutations

resistance mutations

real-time treatment monitoring