Monitoring EGFR T790M mutations by Blocker PCR in plasma of advanced non-small-cell lung cancer patients with EGFR-TKI acquired resistance / 复旦学报（医学版）

ABSTRACT

Objective To evaluate the feasibility of Blocker PCR assays in monitoring T790M mutations in plasma of non-small-cell lung cancer (NSCLC) patients with epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) acquired resistance.Methods Blocker PCR assays were employed to identify mutations in plasma for 127 advanced NSCLC with acquired EGFR-TKI resistance.In addition,the paired tumor re-biopsy or PE samples were obtained to analyze EGFR mutations.Meanwhile,we evaluated the detection accuracy of Blocker PCR assays in comparison with the next generation sequencing (NGS).Results Among the 127 patients,40.15％ (51/127) EGFR T790M was detected in the plasma,78.44％ (40/51) coexisted with an EGFR activating mutation.Additionally,54.54 ％ (6/11) EGFR T790M was identified in re-biopsy tissues,while 43.75 ％ (14/32) were detected in the plasma.Furthermore,the concordance rate of Blocker PCR and NGS in identifying EGFR sensitizing mutations and EGFR T790M mutations was 100％.Conclusions Blocker PCR is a highly sensitive and reliable method in monitoring EGFR T790M mutations in the plasma of NSCLC patients with EGFR-TKI acquired resistance.