Disease monitoring of epidermal growth factor receptor (EGFR)‐mutated non‐small‐cell lung cancer patients treated with tyrosine kinase inhibitors via EGFR status in circulating tumor DNA

作者：Yan Li, Ziyi Xu, Shouzheng Wang, Yixiang Zhu, Di Ma, Yuxin Mu, Jianming Ying, Junling Li, Puyuan Xing · 发表于：Thoracic Cancer · 年份：2022 · DOI：10.1111/1759-7714.14545 · 被引用次数：40 · 研究领域：Lung Cancer Treatments and Mutations、Cancer Genomics and Diagnostics、Lung Cancer Research Studies

OBJECTIVE: Circulating tumor DNA (ctDNA) monitoring proves to be a promising approach to assess response and predict survival in epidermal growth factor receptor (EGFR)-mutated non-small-cell lung cancer (NSCLC) patients treated with tyrosine kinase inhibitors (TKIs). However, whether the dynamic changes in ctDNA EGFR mutation status have the same predictive value as ctDNA remains unknown. This study aims to explore the predictive value of dynamic changes in both ctDNA and ctDNA EGFR status. METHODS: A retrospective analysis was performed using 91 ctDNA samples from a cohort of 28 patients who were diagnosed with EGFR-mutated NSCLC and treated with EGFR-TKIs, including 14 patients treated with first-/second-generation TKIs and 14 treated with osimertinib. Blood samples at baseline (BL), within 4 weeks after TKI initiation (Week4), within 12 weeks before progression (pre-PD), and at progression were collected. The relationship alternatives in ctDNA status, ctDNA EGFR status and response to EGFR-TKIs as well as progression-free survival (PFS) were analyzed. RESULTS: We categorized 20 BL-ctDNA positive patients with available Week4-ctDNA into two groups: ctDNA-clearance (N = 7, 35%) and ctDNA-non-clearance (N = 13, 65%). The ctDNA-clearance group had better PFS than the ctDNA-non-clearance group (ctDNA-clearance vs. ctDNA-non-clearance, p = 0.091, hazard ratio [HR] = 0.42, 95% confidence interval [CI] = 0.15-1.19). According to Week4-EGFR status, we observed that PFS was signifi...