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Lorena Incorvaia

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    P1.13 - Targeted Therapy (Not CME Accredited Session) (ID 945)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/24/2018, 16:45 - 18:00, Exhibit Hall
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      P1.13-16 - The Diagnostic Accuracy of Circulating Tumor DNA for the Detection of EGFR-T790M Mutation in NSCLC: A Systematic Review and Meta-Analysis (ID 14065)

      16:45 - 18:00  |  Author(s): Lorena Incorvaia

      • Abstract
      • Slides


      This meta-analysis aims at evaluating the diagnostic accuracy of circulating tumor (ct) DNA for the detection of epidermal growth factor receptor (EGFR)-T790M mutation in patients with EGFR-positive advanced non-small cell lung cancer (NSCLC) who progressed to prior EGFR-tyrosine kinase inhibitors (TKIs).

      a9ded1e5ce5d75814730bb4caaf49419 Method

      Data from published studies collecting matched blood and tumor tissue samples from patients with EGFR-positive advanced NSCLC who progressed to prior EGFR-TKI were collected by searching in PubMed, Cochrane Library, American Society of Clinical Oncology, European Society of Medical Oncology and World Conference of Lung Cancer meeting proceedings. Studies which evaluated both sensitivity and specificity of plasma-based EGFR-T790M mutation testing by ctDNA analysis were included and pooled sensitivity and specificity with 95% confidence intervals (95% CIs) were calculated.

      4c3880bb027f159e801041b1021e88e8 Result

      A total of twenty-one studies, with 1639 patients, were eligible. The pooled sensitivity of ctDNA analysis was 0.67 (95% CI: 0.64-0.70) and the pooled specificity was 0.80 (95% CI: 0.77-0.83). The positive likelihood ratio (PLR) and negative likelihood ratio (NLR) were 2.67 (95% CI: 1.86-3.82) and 0.46 (95% CI: 0.38-0.54), respectively. The pooled diagnostic odds ratio (DOR) was 7.27 (4.39-12.05) and the AUC of the sROC curve was 0.77. Subgroup analysis by different detection platforms showed that sensitivity, specificity and AUC of ctDNA analysis by real-time (RT)-PCR were: 0.61 (95% CI: 0.57-0.65), 0.82 (95% CI: 0.77-0.87), and 0.70; sensitivity, specificity and AUC of ctDNA analysis by digital (d)PCR were: 0.72 (95% CI: 0.68-0.76), 0.73 (95% CI: 0.67-0.79), and 0.77; sensitivity, specificity and AUC of ctDNA analysis by by next-generation sequencing (NGS) were: 0.87 (95% CI: 0.76-0.95), 0.89 (95% CI: 0.82-0.94), and 0.88, respectively.

      8eea62084ca7e541d918e823422bd82e Conclusion

      The ctDNA analysis represents a promising, non-invasive approach to detect and monitor the T790M mutation status in patients with EGFR-positive advanced NSCLC, with NGS emerging as the most accurate detection platform. Development of standardized methodologies and clinical validation are recommended.


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