Related Experiment Video
Updated: Feb 2, 2026
Using 22C3 Anti-PD-L1 Antibody Concentrate on Biopsy and Cytology Samples from Non-small Cell Lung Cancer Patients
Published on: September 25, 2018
Re-biopsy status among Chinese non-small-cell lung cancer patients who progressed after icotinib therapy
Hanping Wang1, Li Zhang1, Xiaoyan Si1
1Department of Respiratory Medicine, Peking Union Medical College Hospital, Dongcheng District, Beijing 100730, China, zhanglipumch1026@sina.com.
Objective:
Acquired T790M mutations account for 50%-60% of tyrosine kinase inhibitor (TKI)-resistant mechanisms in EGFR mutation-positive (m+) non-small-cell lung cancer (NSCLC) patients, and re-biopsy is recommended to detect these mutations. We investigated the re-biopsy status and the T790M incidence rate in patients after treatment with icotinib, which is the first-generation EGFR-TKI widely used in China.
Patients And Methods:
Target patients had EGFRm+NSCLC, who were progressed after icotinib therapy. The primary end point was the re-biopsy rate (number of cases in which re-biopsies were performed successfully/total number of patients progressed after icotinib therapy). Secondary end points included the T790M mutation incidence rate, differences between the first biopsy and re-biopsy, and details of why re-biopsy was not performed in relevant patients.
Results:
A total of 77 adenocarcinoma patients were evaluated (median age, 58 years). Tissue re-biopsy was successful in 41 patients (53.2%). Compared with the first biopsy, percutaneous tissue biopsies increased from 51.2% to 70.7% (P=0.008), while bronchoscopy biopsies and the surgical rate decreased from 19.5% to 14.6% (P<0.001) and 17.1% to 7.3% (P<0.001), respectively. Primary lung lesions were more common in the first biopsy than in re-biopsy (80.5% vs 65.9%, P=0.008), but metastatic lesions were more often selected for re-biopsy (14/41 [34.1%], including metastases in the bone, lymph nodes, and liver). The incidence rate of T790M was 56.1% (23/41). The reasons for not performing re-biopsies included lesion sizes and/or locations unsuitable for biopsy (n=17), a positive circulating tumor DNA (ctDNA) result (n=3), patient unwillingness (n=7), older age or severe comorbidity (n=4), and poor health (n=5). No severe complications were found.
Conclusion:
In this real-world study, the re-biopsy rate was 53.2% and the incidence rate of T790M mutations was 56.1%. Further efforts are needed to increase the re-biopsy rate in patients who progress after icotinib therapy.
Insights
Re-biopsy after icotinib treatment for EGFR mutation-positive non-small-cell lung cancer (NSCLC) was successful in 53.2% of patients. The T790M mutation, a resistance mechanism, was found in 56.1% of these cases.
Area of Science:
- Oncology
- Molecular Biology
- Cancer Research
Background:
- Acquired T790M mutations are a major cause of resistance to tyrosine kinase inhibitors (TKIs) in EGFR mutation-positive non-small-cell lung cancer (NSCLC).
- Re-biopsy is recommended to detect T790M mutations after TKI treatment failure.
- Icotinib is a first-generation EGFR-TKI widely used in China.
Purpose of the Study:
- To investigate the re-biopsy rate in patients with EGFR mutation-positive NSCLC after progression on icotinib therapy.
- To determine the incidence rate of T790M mutations in these patients.
- To analyze differences in biopsy types and targets between initial and re-biopsies.
Main Methods:
- Retrospective analysis of 77 patients with EGFR mutation-positive NSCLC who progressed after icotinib therapy.
- Evaluation of successful re-biopsy rates and T790M mutation incidence.
- Comparison of biopsy methods (percutaneous, bronchoscopy, surgical) and lesion sites (primary lung, metastatic).
Main Results:
- Successful re-biopsy was achieved in 53.2% of patients (41/77).
- The incidence of T790M mutations was 56.1% (23/41).
- Percutaneous biopsies increased, while bronchoscopy and surgical biopsies decreased; metastatic lesions were more frequently biopsied on re-biopsy.
Conclusions:
- The re-biopsy rate after icotinib failure in EGFR mutation-positive NSCLC patients was 53.2%, with a T790M mutation incidence of 56.1%.
- Further strategies are needed to improve re-biopsy rates in this patient population.
Related Concept Videos
02:49Cancer Therapies
However, cancer treatments can pose several challenges, as therapies used to kill cancer cells are generally also toxic to normal cells. Moreover, cancer cells mutate rapidly and can develop resistance to chemical agents or radiation therapy. Besides, all types of cancer cells may not respond to the same therapy. Some cancer cells respond to one...
03:03mTOR Signaling and Cancer Progression
The mTOR pathway or the...
02:57Targeted Cancer Therapies
There are several types of targeted therapies against...
01:47Lung Capacity
01:26Marcia's Theory of Identity Status
00:59Gene Therapy