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E.B. Hansen
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P2.04 - Poster Session/ Biology, Pathology, and Molecular Testing (ID 234)
- Event: WCLC 2015
- Type: Poster
- Track: Biology, Pathology, and Molecular Testing
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P2.04-096 - Liquid Biopsies in Patients with EGFR Mutated Non-Small Cell Lung Cancer Undergoing Curative Treatment (ID 1422)
09:30 - 09:30 | Author(s): E.B. Hansen
- Abstract
Background:
A blood based test for detection of EGFR mutations has been developed. Studies have shown a correlation between level of mutations in the blood and course of the disease in stage IV patients, suggesting that the test could be used as a monitoring device. No studies have been conducted examining whether the blood test can be used to monitor patients who undergo curative treatment.
Methods:
Six patients with EGFR mutated tumors were monitored with continuous blood samples from the time of diagnosis until relapse, death or present date. The blood samples were tested for the level of EGFR mutations using the Cobas® EGFR Mutation Test developed for plasma DNA (Roche Molecular Systems, Inc.). Results were compared to the clinical course of the disease.
Results:
Operated without adjuvant chemotherapy (n=3, all patients with T1N0M0 disease). In two patients there were no measurable mutations in the blood samples at any point. One patient is at present date without sign of relapse after 3 years and attends follow up. The other patient died of non-cancer related causes. The third patient had declining level of mutations the first two years after the operation but the mutated DNA has never reached zero. Operated with adjuvant chemotherapy (n=1, T2N2M0). Mutations were measurable before operation and declined to zero after. One year after the operation, metastatic disease (CNS) was discovered along with a rise in mutation level, which again declined after local irradiation and initiation of erlotinib treatment. Chemoradiotherapy (n=2, T2N2-3M0). One of these patients had measurable levels of mutations initially, which declined to zero during the course of treatment with chemoradiotherapy and a supplement of erlotinib. Metastatic disease (CNS) was found during the treatment, and the patient proceeded with erlotinib treatment and cerebral irradiation. The patient died due to disease progression 9 months later, no measurable mutated DNA was identified. In contrast, another patient had no measurable mutations until after relapse was detected.
Conclusion:
Our results suggest that in some cases monitoring the level of EGFR mutations in the blood might be a valuable tool in the detection of relapse in patients who have undergone curative treatment for their lung cancer. Further investigations are warranted to elucidate the subject. We have initiated a project, where we prospectively follow all patients with EGFR mutated NSCLC regardless of stage and treatment modality and we examine their blood for EGFR mutations every time a blood sample is drawn.
