Noninvasive Detection of EGFR T790M in Gefitinib or Erlotinib Resistant Non–Small Cell Lung Cancer

摘要: Purpose: Tumors from 50% of epidermal growth factor receptor ( EGFR ) mutant non–small cell lung cancer patients that develop resistance to gefitinib or erlotinib will contain a secondary T790M mutation. As most do not undergo repeated tumor biopsies we evaluated whether could be detected using plasma DNA. Experimental Design: DNA 54 with known clinical response was extracted and used detect both -activating mutations. Forty-three (80%) had sequencing mutant/wild type: 30/13) seven also gefitinib/erlotinib-resistant tumors. mutations were two methods, the Scorpion Amplification Refractory Mutation System WAVE/Surveyor, combined whole genome amplification. Results: Both identified in 70% (21 30) (5 7) 54% (15 28) prior gefitinib/erlotinib, 29% (4 14) stable disease, 0% (0 12) primary progressive disease untreated gefitinib/erlotinib. Conclusions: can gefitinib- erlotinib-resistant patients. This noninvasive method may aid monitoring drug directing course subsequent therapy.