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Presence of liver metastasis correlated with high tumor abundance and indicated adverse prognostic feature in EGFR mutation non-small-cell lung cancer patients

  • 0Division of Medical Oncology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and The King Chulalongkorn Memorial Hospital, Bangkok, 10330, Thailand.
Scientific Reports +

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January 2, 2025

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January 2, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

The Idylla™ ctEGFR assay detects epidermal growth factor receptor (EGFR) mutations in non-small cell lung cancer (NSCLC) patients. High EGFR mutation levels and liver metastasis predict poorer outcomes for NSCLC patients treated with EGFR-tyrosine kinase inhibitors.

Area Of Science

  • Oncology
  • Molecular Diagnostics
  • Genetics

Background

  • Epidermal growth factor receptor (EGFR) mutations drive non-small cell lung cancer (NSCLC) and are targeted by EGFR-tyrosine kinase inhibitors (TKIs).
  • Treatment response to EGFR-TKIs varies, and acquired resistance is common, necessitating better predictive biomarkers.
  • Assessing tumor burden and predicting treatment outcomes in advanced NSCLC remains a clinical challenge.

Purpose Of The Study

  • To evaluate the Idylla™ ctEGFR mutation assay's utility in quantifying EGFR mutation abundance in plasma.
  • To correlate ctEGFR levels with radiographic tumor burden, clinical outcomes, and metastasis patterns.
  • To identify predictors of treatment response and survival in advanced NSCLC patients receiving EGFR-TKIs.

Main Methods

  • A prospective cohort of 130 advanced NSCLC patients with EGFR mutations was enrolled.
  • Plasma samples were collected pre- and post-treatment for EGFR mutation analysis using the Idylla™ ctEGFR assay.
  • Correlation analyses were performed between ctEGFR levels, radiographic assessments, progression-free survival (PFS), and overall survival (OS).

Main Results

  • Eighty-nine patients were analyzed, categorized by ctEGFR levels: undetectable (49.5%), detectable CqMut-high (23.5%), and detectable CqMut-low (27%).
  • Median PFS was significantly longer in the undetectable ctEGFR group (13.4 months) compared to CqMut-high (10.4 months) and CqMut-low (5.9 months).
  • Liver metastasis was significantly associated with higher tumor burden (ctEGFR CqMut-low) and was an independent predictor of reduced PFS and OS (HR=2.41 and HR=2.96, respectively).

Conclusions

  • Pretreatment ctEGFR detection using the Idylla™ assay serves as a surrogate marker for tumor abundance and burden in NSCLC.
  • The Idylla™ ctEGFR assay effectively stratifies patients based on tumor burden and predicts treatment outcomes.
  • Presence of liver metastasis is a critical clinical predictor associated with high tumor abundance and worse outcomes in EGFR-mutated NSCLC patients treated with EGFR-TKIs.

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