奥西默替尼
T790米
医学
肺癌
内科学
肿瘤科
液体活检
实体瘤疗效评价标准
表皮生长因子受体
活检
进行性疾病
癌症
吉非替尼
埃罗替尼
化疗
作者
Jordi Remón,Caroline Caramella,Cécile Jovelet,Ludovic Lacroix,Andrew Lawson,Sarah Smalley,Karen Howarth,Davina Gale,E. Green,Vincent Plagnol,Nitzan Rosenfeld,David Planchard,M.V. Bluthgen,Anas Gazzah,Chloé Pannet,Claudio Nicotra,Édouard Auclin,Jean Charles Soria,Benjamin Besse
标识
DOI:10.1093/annonc/mdx017
摘要
Approximately 50% of epidermal growth factor receptor (EGFR) mutant non-small cell lung cancer (NSCLC) patients treated with EGFR tyrosine kinase inhibitors (TKIs) will acquire resistance by the T790M mutation. Osimertinib is the standard of care in this situation. The present study assesses the efficacy of osimertinib when T790M status is determined in circulating cell-free tumour DNA (ctDNA) from blood samples in progressing advanced EGFR-mutant NSCLC patients.ctDNA T790M mutational status was assessed by Inivata InVision™ (eTAm-Seq™) assay in 48 EGFR-mutant advanced NSCLC patients with acquired resistance to EGFR TKIs without a tissue biopsy between April 2015 and April 2016. Progressing T790M-positive NSCLC patients received osimertinib (80 mg daily). The objectives were to assess the response rate to osimertinib according to Response Evaluation Criteria in Solid Tumours (RECIST) 1.1, the progression-free survival (PFS) on osimertinib, and the percentage of T790M positive in ctDNA.The ctDNA T790M mutation was detected in 50% of NSCLC patients. Among assessable patients, osimertinib gave a partial response rate of 62.5% and a stable disease rate of 37.5%. All responses were confirmed responses. After median follow up of 8 months, median PFS by RECIST criteria was not achieved (95% CI: 4-NA), with 6- and 12-months PFS of 66.7% and 52%, respectively.ctDNA from liquid biopsy can be used as a surrogate marker for T790M in tumour tissue.
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