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J Pathol Transl Med. 2019 May;53(3):153-158. doi: 10.4132/jptm.2019.02.22. Epub 2019 Feb 28.

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

Author information

1
Department of Pathology, Pusan National University School of Medicine, Yangsan, Korea.
2
Department of Pathology, Yonsei University College of Medicine, Seoul, Korea.
3
Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
4
Department of Pathology, Ewha Womans University Mokdong Hospital, Seoul, Korea.
5
Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
6
Department of Pathology, Konkuk University School of Medicine, Seoul, Korea.
7
Department of Pathology, Inha University School of Medicine, Incheon, Korea.
8
Department of Pathology, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea.
9
Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
10
Department of Pathology, Seoul National University Bundang Hospital, Seongnam, Korea.
11
Department of Pathology, National Cancer Center, Goyang, Korea.

Abstract

Liquid biopsy for detection of mutation from 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 cell lung cancer patients who harbor activating EGFR mutation. During the course of treatment, resistance against TKI arises which can be contributed to EGFR T790M mutation in about 50-60% of patients. Third generation TKI may overcome the resistance. In patients who cannot undergo tissue biopsy due to variable reasons, liquid biopsy is an excellent alternative for the detection of EGFR T790M mutation. However, this relatively novel method requires standardization and vigorous quality insurance. Thus, a standard set of guideline recommendations for liquid biopsy for EGFR mutation testing suitable for the Korean medical community is necessary. In this article, we propose a set of provisional guideline recommendations that was discussed and approved by the Cardiopulmonary Pathology Study Group of the Korean Society of Pathologists.

KEYWORDS:

Carcinoma, non-small-cell lung; Circulating tumor DNA; Epidermal growth factor receptor; Liquid biopsy; T790M

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