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This paper aims to determine the rate of epidermal growth factor receptor (EGFR) gene mutations in advanced and metastatic squamous cell lung cancer in Vietnamese patients. EGFR mutation testing was performed on 559 formalin-fixed paraffin-embedded tissue samples from advanced and metastatic squamous cell lung cancer patients by real-time PCR. The results showed that EGFR mutations were found in 8.4%. Most of them were exon 19 deletions, approximately 51.1%. Multivariate analysis showed that EGFR mutations were more prevalent in gender (p

This study aims to describe EGFR mutation status detected in plasma samples and analyze some related factors in non-small cell lung cancer patients after treatment with the generation I and II Tyrosine Kinase inhibitors at Bach Mai Hospital. Patients and methods: A retrospective descriptive study on 75 patients with non-small cell lung cancer tested for EGFR mutations in plasma after treatment with 1st or 2nd EGFR-TKIs in 2019-2020. Results: EGFR mutations were detected in 97.3% plasma samples; the T790M mutation accounted for 37.3% and is accompanied by a sensitive mutation TKI; The T790M mutations ratio after treatment was higher than before treatment with TKIs (p < 0.001); the median total duration of EGFR-TKI treatment was significantly longer in patients with T790M mutation than in those without (16.8 months vs 12.5 months, p = 0.005); the T790M mutation ratio was higher in patients with a deletion on exon 19 than in L858R mutation on exon 21 (p=0.028), in Erlotinib treatment group higher than in Gefitinib and Afatinib treatment group (51.4% vs. with 20.0% and 33.3%, p=0.039). Conclusions: EGFR mutation plasma test helps to monitor disease progression and detect resistance mutations T790M in NSCLC patients after TKI generation I and II. Keywords: non-small cell lung cancer, EGFR mutations, T790M mutations, TKIs.. References [1] H. Sung et al., Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers In 185 Countries, CA: A Cancer Journal for Clinicians. Vol. 71, No. 3, 2021, pp. 209-249, https://doi.org/10.3322/caac.21660.[2] N. V. Hieu, Oncology, Medical Publisher, 2015.[3] P. N. Ding et al., Plasma Pre-treatment T790M Relative Allelic Frequency in Patients with Advanced EGFR-mutated Non-small Cell Lung Cancer Predicts Treatment Response to Subsequent-Line Osimertinib, Translational Lung Cancer Research, Vol. 10, No. 4, 2021, pp. 1623-1634, https://doi.org/10.1186/s40169-020-0269-y.[4] N. Yamamoto et al., Erlotinib Plus Bevacizumab Vs Erlotinib Monotherapy as First-line Treatment for Advanced EGFR Mutation-positive Non-squamous Non-small-cell Lung Cancer: Survival Follow-up Results of the Randomized JO25567 Study, Lung Cancer, Vol. 151, 2021, pp.20-24, https://doi.org/10.1016/j.lungcan.2020.11.020.[5] D. S. Ettinger et al., NCCN Guidelines Insights: Non–Small Cell Lung Cancer, Version 2, 2021: Featured Updates to the NCCN Guidelines", Journal of the National Comprehensive Cancer Network, Vol. 19, No. 3, 2021, pp. 254-266, https://doi.org/10.6004/jnccn.2021.0013.[6] K. Usui et al., Plasma ctDNA Monitoring During Epidermal Growth Factor Receptor (EGFR)-Tyrosine Kinase Inhibitor Treatment in Patients With EGFR-mutant Non-small Cell Lung Cancer (JP-CLEAR trial), Japanese Journal of Clinical Oncology, Vol. 49, No. 6, 2021, pp. 554-558, https://doi.org/10.1093/jjco/hyz023.[7] M. Nagasaka et al., Liquid Biopsy for Therapy Monitoring in Early-stage Non-small Cell Lung Cancer, Molecular Cancer, Vol. 20, No. 1, 2021, pp. 82, https://doi.org/10.1186/s12943-021-01371-1.[8] M. D. Re et al., Incidence of T790M in Patients with NSCLC Progressed to Gefitinib, Erlotinib, and Afatinib: A Study on Circulating Cell-free DNA, Clinical Lung Cancer, Vol. 21, No. 3, 2020, pp. 232-237, https://doi.org/10.1016/j.cllc.2019.10.003.[9] S. Jenkins et al., Plasma ctDNA Analysis for Detection of the EGFR T790M Mutation in Patients with Advanced Non–small Cell Lung Cancer", Journal of Thoracic Oncology, Vol. 12, No. 7, 2017, pp. 1061-1070, https://doi.org/10.1016/j.jtho.2017.04.003.[10] R. Ko et al., Frequency of EGFR T790M Mutation and Multimutational Profiles of Rebiopsy Samples from Non-small Cell Lung Cancer Developing Acquired Resistance to EGFR Tyrosine Kinase Inhibitors in Japanese Patients, BMC Cancer, Vol. 16, No. 1, 2016, pp. 864, https://doi.org/10.1186/s12885-016-2902-0.[11] N. Matsuo et al., Association of EGFR Exon 19 Deletion and EGFR-TKI Treatment Duration with Frequency of T790M Mutation in EGFR-Mutant Lung Cancer Patients, Scientific Reports, Vol. 6, No. 1, 2016, pp. 36458 , https://doi.org/10.1038/srep36458.[12] W. Fanget al., EGFR Exon 20 Insertion Mutations and Response to Osimertinib in Non-small-cell Lung Cancer, BMC Cancer, Vol. 19, No. 1, 2019, pp. 1-9, https://doi.org/10.1186/s12885-019-5820-0.[13] D. T. Hien, P. C. Phuong, Analysis of EGFR Mutations in Paraffin-covered Tissue Samples and some Related Factors from Non-small Cell Lung Cancer Patients Over 60 Years Old, Science and Technology Vietnam, Vol. 62, No. 7, 2020, pp. 1-5[14] S. Hong et al., Concomitant Genetic Alterations with Response to Treatment and Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitors in Patients with EGFR-Mutant Advanced Non–small Cell Lung Cancer, JAMA Oncology, Vol. 4, No. 5, 2018, pp. 739-742, https://doi.org/10.1001/jamaoncol.2018.0049.

e13121 Background: Lung cancer patients with mutations in the epidermal growth factor receptor (EGFR) are primary candidates for EGFR-targeted therapy. Reliable analyses of such mutations have previously been possible only in tumor tissue. Here, we demonstrate that mutations can be detected in plasma samples of non-small cell lung cancer patients at Bach Mai Hospital and relation of different variables to the frequency of EGFR mutations. Methods: 193 patients with non-small cell lung cancer were identified with EGFR mutation by cobas EGFR Mutation Test v2 kit (Roche Diagnostics, USA), evaluating the EGFR mutation status with different variables. Results: The EGFR mutation rate was 43%, common in patients with adenocarcinoma, female, non-smoking, late stage disease. The rate of EGFR T790M mutation was 36.1%. Among 78 patients who was previous treated TKIs, EGFR mutation rate was 73.1% and the rate of EGFR T790M mutation was 50.8% at the time of progression. The concordance of EGFR mutation from plasma sample with tissue sample was 81%. Conclusions: EGFR mutation in plasma sample results was not different from those in tissue samples and similar with result of studies in Vietnam and worldwide.

e13120 Background: To determine the epidermal growth factor receptor ( EGFR) mutation status in non-small cell lung cancer (NSCLC) patients in Vietnamese population at Bach Mai Hospital, and relation of different variables to the frequency of EGFR mutations. Methods: The EGFR mutation status of 1451 tissue samples in NSCLC patients and correlation among different variables of age, gender, smoking habit and histology groups were evaluated. Results: A total of EGFR mutation analysis was performed, with an overall mutation rate of 40.7%. The most prevalent categories were in-frame deletions in exon 19 (57.2% of the overall mutations); followed by L858R and L861Q in exon 21 (35.7%); exon 18 (4,6%); double mutation: 2.9%; The T790M mutation in exon 20 represented approximately 2.5%; The pooled prevalence of EGFR mutation was higher in female (60.6%), non-smokers (61.1%), and patients with adenocarcinoma (42.2%). Conclusions: The prevalence of EGFR mutations of NSCLC in Vietnam is higher than that in the West, but comparably equal to that in some Asian countries. It is associated with female sex, non-smoker status, and adenocarcinoma, sample tissue type and age, but not depends on disease stage and tumor sampling.