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D. Kumar
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P3.02b - Poster Session with Presenters Present (ID 494)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 12/07/2016, 14:30 - 15:45, Hall B (Poster Area)
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P3.02b-022 - Early Experience of Detecting EGFR Activating Mutations in Cell Free DNA Using Droplet Digital PCR (ID 5859)
14:30 - 14:30 | Author(s): D. Kumar
- Abstract
Background:
: Early detection of resistance conferring epidermal growth factor receptor (EGFR) T790M mutation is of clinical significance in previously EGFR positive NSCLC patients.
Methods:
Plasma from 40 advanced NSCLC patients with known L858R or Del 19 745_750 Mutations were tested for cell free DNA on Droplet Digital PCR. This included biopsy confirmed treatment naive cases as well as those who developed clinical resistance to tyrosine kinase inhibitors. The later cases were examined for previous known and new T790M mutations using highly sensitive Droplet Digital PCR. Where ever feasible the results were compared to the secondary biopsy findings, duration of development of new T790M mutation and its serial plasma quantification results.
Results:
20 Treatment naive biopsy positive DEL19 /L858R cases were tested for cell free DNA. All cases were positive with values ranging from .04% to 24%. 19 cases were checked for primary and secondary mutations on progression of disease. 12 cases showed secondary mutation along with primary mutation. The values of T790M mutation ranged from 0.04% to 4.5%. We also had 3 cases with biopsy and cell free correlation of secondary mutation. None of them correlated.
Conclusion:
Droplet digital PCR is a robust platform to detect the primary driver EGFR mutations and can be used as a substitute / addendum to biopsy for initiating early treatment. It also appears to be too sensitive for detection of secondary T790M mutations. However response to treatment in patients with minimal cell free T790M values in plasma may need to be further investigated for clinical utilization of this platform.