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Thoracoscopic rebiopsy to detect the T790M mutation after postoperative recurrence

Masatsugu Hamaji1, Hideki Motoyama1, Toshi Menju1

  • 1Department of Thoracic Surgery, Kyoto University, Kyoto, Japan.

Interactive Cardiovascular and Thoracic Surgery
|April 5, 2018
PubMed

Insights

Thoracoscopic rebiopsy can detect the T790M mutation in non-small cell lung cancer patients who develop resistance to first-line epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs). This procedure may aid in managing select patients with acquired resistance.

Area of Science:

  • Oncology
  • Thoracic Surgery

Background:

  • Non-small cell lung cancer (NSCLC) patients with mutated epidermal growth factor receptor (EGFR) may experience recurrence after pulmonary resection.
  • Acquired resistance to first-line EGFR-tyrosine kinase inhibitors (EGFR-TKIs) is a clinical challenge.
  • The T790M mutation is a common mechanism of acquired resistance to EGFR-TKIs.

Observation:

  • This study evaluated thoracoscopic rebiopsy in 4 NSCLC patients with postoperative recurrence and acquired resistance to first-line EGFR-TKIs.
  • The T790M mutation status was assessed via rebiopsy in patients who became resistant to prior treatment.
  • The procedure was performed to identify resistance mechanisms.

Findings:

  • Thoracoscopic rebiopsy successfully detected the T790M mutation in patients resistant to first-line EGFR-TKIs.
  • The limited experience suggests thoracoscopic biopsy is associated with low morbidity.
  • The procedure provided actionable information for patient management.

Implications:

  • Thoracoscopic rebiopsy can be a valuable tool for detecting the T790M mutation in NSCLC patients with acquired resistance.
  • This diagnostic approach may guide treatment decisions, potentially improving outcomes for select patients.
  • Further research with larger cohorts is warranted to confirm these findings.

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