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Thorac Cancer. 2018 Jul;9(7):856-864. doi: 10.1111/1759-7714.12762. Epub 2018 May 14.

Feasibility of re-biopsy and EGFR mutation analysis in patients with non-small cell lung cancer.

Author information

1
Department of Internal Medicine, Chonnam National University Medical School, Gwangju, South Korea.
2
Lung and Esophageal Cancer Clinic, Chonnam National University Hwasun Hospital, Jeonnam, South Korea.
3
Department of Pathology, Chonnam National University Medical School, Gwangju, South Korea.

Abstract

BACKGROUND:

In cases of EGFR-tyrosine kinase inhibitor (TKI) failure, re-biopsy may be useful to understand resistance mechanisms and guide further treatment decisions. However, performing re-biopsy is challenging because of several hurdles. We assessed the feasibility of re-biopsy in advanced non-small cell lung cancer (NSCLC) patients in real-world clinical practice.

METHODS:

We retrospectively reviewed the clinical and pathologic data of advanced NSCLC patients who experienced disease progression after previous treatment with EGFR-TKIs at a single tertiary hospital in Korea between January 2014 and December 2016. Re-biopsy specimens included small biopsy, surgical tissue, or liquid-based cytology. EGFR mutation was tested using peptide nucleic acid-mediated clamping PCR.

RESULTS:

Of the 230 NSCLC patients that experienced progression after EGFR-TKI therapy, 105 (45.7%) underwent re-biopsy. Re-biopsy was successfully performed in 94 (89.5%) patients, and 11 patients were diagnosed with no malignancy. The complication rate was 8.6%, including seven cases of pneumothorax. EGFR mutation testing was performed on 75 patients using re-biopsy specimens. Of the 57 patients who had sensitizing mutations at diagnosis, T790M mutations were found in 19 (33.3%), while 38 (66.7%) had no T790M mutation. Multivariate analysis showed that the re-biopsy group was younger (P = 0.002) and exhibited a previous response to EGFR-TKIs (P < 0.001).

CONCLUSION:

Re-biopsy in advanced NSCLC is feasible in real world clinical practice, particularly in younger patients and those who achieved a previous response to EGFR-TKIs.

KEYWORDS:

EGFR mutation; T790M; re-biopsy

PMID:
29761660
PMCID:
PMC6026616
DOI:
10.1111/1759-7714.12762
[Indexed for MEDLINE]
Free PMC Article

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