1. Direct sequencing in cytological specimens as a useful strategy for detecting EGFR mutations in non-small cell lung cancer patients.
- Author
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Cho MC, Choi CM, Kim S, Jang S, Jang S, Park CJ, Chi HS, Peyton MJ, Lee W, Chun S, Kim SW, and Min WK
- Subjects
- Adult, Aged, Aged, 80 and over, Base Sequence, Carcinoma, Non-Small-Cell Lung pathology, Carcinoma, Non-Small-Cell Lung therapy, Cell Line, Tumor, Cytological Techniques, Female, Humans, Lung Neoplasms pathology, Lung Neoplasms therapy, Male, Middle Aged, Neoplasm Metastasis, Real-Time Polymerase Chain Reaction, Reproducibility of Results, Body Fluids metabolism, Carcinoma, Non-Small-Cell Lung genetics, DNA Mutational Analysis methods, ErbB Receptors genetics, Lung Neoplasms genetics
- Abstract
Background: New therapeutics targeting epidermal growth factor receptor (EGFR) have significantly improved tumor responses to therapy in non-small cell lung cancer (NSCLC) patients. Molecular testing for EGFR mutations informs important therapeutic decisions in clinical practice. In this study, we sought to validate the clinical relevance of sequencing-based EGFR mutation testing combined with cytological analysis using body fluid specimens., Methods: Two NSCLC cell lines were used in sensitivity analyses. In addition, we performed cytological analyses and directly sequencing of exons 18-21, for 32 specimens. The absence of EGFR mutations determined by direct sequencing in 14 specimens was confirmed by real-time PCR. Changes made to patients' therapeutic strategies after reports of EGFR mutation status were investigated by querying electronic medical records., Results: Sensitivity studies showed that detection of in-frame deletions in exon 19 and point mutations in exon 21 was possible in specimens containing 10% and 5% mutant DNA, respectively. In clinical practice, EGFR mutations were detected in 18 of 32 specimens (56.3%). Twelve patients with EGFR mutations detected by direct sequencing were started on treatment with EGFR tyrosine kinase inhibitor (TKI) after reports of EGFR mutation. EGFR-TKI therapy was discontinued for two patients with TKI-resistant T790M mutation. The results of real-time PCR were consistent with those of direct sequencing in 13 of 14 specimens (92.9%) in which no mutation was detected by direct sequencing., Conclusions: Combined direct sequencing and cytological analysis of body fluid specimen might be clinically useful and sensitive test for the detection of EGFR mutations in NSCLC patients.
- Published
- 2011
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