Author of

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  P3.06 - Poster Session 3 - Prognostic and Predictive Biomarkers (ID 178)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Biology
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/30/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 12463

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    P3.06-023 - Usefulness of Pleural Effusion for the Detection of EGFR Mutation by Using Direct Sequencing and PNA Clamping (ID 2037)

    09:30 - 09:30  |  Author(s): S.J. Kim
    • Abstract

    Background
    Pleural fluid samples are useful when tumor tissues are not available for mutation analysis. Moreover, the advantages of using pleural fluid are that it is easily accessible, can be sampled by relatively non-invasive methods, and can be repeatedly sampled. Approaches for examining molecular biomarkers in body fluids such as effusion may be clinically helpful in predicting the response to EGFR-TKI treatment.

    Methods
    Fifty-seven patients with malignant pleural effusion were enrolled in the study. EGFR mutations were assessed by direct sequencing and PNA clamping using tumor tissues, cell blocks, pleural effusions, and sera. The diagnostic performance of pleural effusion was investigated.

    Results
    Among the 57 patients with malignant effusion, 37 patients were NSCLC, 11 were SCLC and 9 were extrapulmonary cancer. Twenty patients including 11 SCLC and 9 extrapulmonary cancer showed negative for EGFR mutational status. Among the 37 NSCLC patients, the diagnostic performance of pleural effusion compared with the combination of tumor tissue and cell blocks showed 89% sensitivity, 100% specificity, positive predictive value of 100%, and negative predictive value of 95% by PNA clamping, and 67% sensitivity, 90% specificity, positive predictive value of 75%, and negative predictive value of 86% by directing sequencing. A patient in whom an EGFR mutation was identified in pleural effusion only by PNA clamping showed a significant response to EGFR tyrosine kinase inhibitor (EGFR-TKI) treatment.

    Conclusion
    Pleural effusion had a diagnostic performance for the detection of EGFR mutations in NSCLC that was comparable to that of tumor tissues and cell blocks. The diagnostic performance of PNA clamping was good compared with that of direct sequencing. A more sensitive and accurate detection of EGFR mutations would benefit patients by allowing a better prediction of the response to EGFR-TKI treatment.