J Pathol Transl Med.  2019 May;53(3):153-158. 10.4132/jptm.2019.02.22.

Provisional Guideline Recommendation for EGFR Gene Mutation Testing in Liquid Samples of Lung Cancer Patients: A Proposal by the Korean Cardiopulmonary Pathology Study Group

• Shin DH
• Shim HS
• Kim TJ
• Park HS
• Choi YL
• Kim WS
• Kim L
• Chang SH
• Song JS
• Kim HJ
• Han JH
• Lee CH
• Lee GK
• Jang SJ
• Korean Cardiopulmonary Pathology Study Group

• KMID: 2449337
• DOI: http://doi.org/10.4132/jptm.2019.02.22

Abstract

Liquid biopsy for detection of mutation from circulating tumor DNA is a new technology which is attractive in that it is non-invasive. Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKI) is an effective first line drug for advanced non-small cell lung cancer patients who harbor activating EGFR mutation. During the course of treatment, resistance against TKI arises which can be contributed to EGFR T790M mutation in about 50-60% of patients. Third generation TKI may overcome the resistance. In patients who cannot undergo tissue biopsy due to variable reasons, liquid biopsy is an excellent alternative for the detection of EGFR T790M mutation. However, this relatively novel method requires standardization and vigorous quality insurance. Thus, a standard set of guideline recommendations for liquid biopsy for EGFR mutation testing suitable for the Korean medical community is necessary. In this article, we propose a set of provisional guideline recommendations that was discussed and approved by the Cardiopulmonary Pathology Study Group of the Korean Society of Pathologists.

Keyword

Carcinoma, non-small-cell lung; Epidermal growth factor receptor; T790M; Circulating tumor DNA; Liquid biopsy

MeSH Terms

Biopsy
Carcinoma, Non-Small-Cell Lung
DNA
Genes, erbB-1*
Humans
Insurance
Lung Neoplasms*
Lung*
Methods
Pathology*
Protein-Tyrosine Kinases
Receptor, Epidermal Growth Factor
DNA
Protein-Tyrosine Kinases
Receptor, Epidermal Growth Factor

Figure

• 

  Fig. 1. Proposed diagnostic algorithm for the detection of epidermal growth factor receptor (EGFR) T790M mutation. NSCLC, nonsmall cell lung cancer; TKI, tyrosine kinase inhibitor; CTx, chemotherapy.

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