2024 Asia Conference on Lung Cancer (ACLC) - Poster & ePosters-PP01.42

PP01.42 - Takayuki Takahama

Pdf Summary

The study by Takahama et al. focuses on the detection and prognosis of overlooked rare EGFR mutations in non-small cell lung cancer (NSCLC) using multigene testing, specifically the OncomineTM Dx Target Test Multi-CDx System (ODxTT), a widely used tool for lung cancer treatment in Japan. Identifying rare molecular variants of driver mutations remains challenging for precision oncology. The study aimed to verify if ODxTT overlooked druggable EGFR mutations by analyzing data from patients diagnosed with advanced/recurrent NSCLC between June 2020 and August 2023.<br /><br />The study included 418 patients with a median age of 73, predominantly male, and primarily diagnosed with adenocarcinoma. It found that while EGFR mutations like Ex19, L858R, and Ex20Ins were identified in various proportions, the ODxTT failed to detect 10 actionable EGFR mutations in 12.2% of cases initially classified as mutation-free. These findings underscore the need for comprehensive genomic profiling in cases with high clinical suspicion of EGFR mutations to ensure missed mutations are identified.<br /><br />Tables within the study provide detailed clinical characteristics and specifics of detected mutations, highlighting the critical nature of accurate detection and analysis in tailoring NSCLC treatment. For instance, a representative table lists various EGFR mutations, their amino acid and nucleotide changes, verification in other diagnostic platforms, and responses to tyrosine kinase inhibitors (TKIs) like osimertinib, illustrated with case studies and imaging results.<br /><br />In conclusion, while ODxTT is a potent diagnostic tool, its limitations in detecting certain actionable EGFR mutations indicate the importance of thorough genomic investigations to enhance personalized oncology and improve NSCLC prognosis and treatment efficacy.

Keywords

EGFR mutations

non-small cell lung cancer

NSCLC

multigene testing

Oncomine Dx Target Test

ODxTT

precision oncology

genomic profiling

tyrosine kinase inhibitors

personalized oncology