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Hengrui Liang



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    Lunch & Poster Display session (ID 58)

    • Event: ELCC 2019
    • Type: Poster Display session
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 4/11/2019, 12:30 - 13:00, Hall 1
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      41P - Diagnostic accuracy of droplet digital PCR (ddPCR) and amplification refractory mutation system PCR (ARMS-PCR) for detecting EGFR mutation in cell-free DNA of advanced lung cancer: A meta-analysis (ID 366)

      12:30 - 13:00  |  Author(s): Hengrui Liang

      • Abstract
      • Slides

      Background

      Epidermal growth factor receptor (EGFR) mutation testing in plasma cell-free DNA (cfDNA) from advanced lung cancer patients is an emerging clinical tool. This non-invasive approach may offer genotyping information but prevent patients from the shortcomings of invasive and repeated biopsies. This meta-analysis was designed to determine the diagnostic accuracy of two common PCR systems, ddPCR and ARMS-PCR, for detecting EGFR mutation in cfDNA.

      a9ded1e5ce5d75814730bb4caaf49419 Methods

      A systematic search was carried out based on electronic databases. Data from eligible studies were extracted and pooled to calculate the sensitivity, specificity, diagnostic odds ratio (DOR), and area under the summary receiver-operating characteristic curve (AUROC), using tissue biopsy results as the standard method.

      20c51b5f4e9aeb5334c90ff072e6f928 Results

      Twenty-three studies involving 4,725 cases were identified and included. The plasma testing sensitivity, specificity, DOR and AUROC, compared with the matched tumor tissues, were 71.7% (95% CI, 67.6%-75.5%), 96.4% (95% CI, 94.2%-97.9%), 39.3 (95% CI, 21.2-73.1), 0.87 (95% CI, 0.80-0.94) for ddPCR, and 65.3% (95% CI, 62.9%-67.6%), 98.2% (95% CI, 97.6%-98.7%), 52.8 (95% CI, 26.3-106.1), 0.71 (95% CI, 0.52-0.91) for ARMS-PCR, respectively. In studies simultaneously comparing the two platforms, we observed no significant difference in specificity (P = 0.473) and sensitivity (P = 0.960) between ddPCR and ARMS-PCR, regardless of EGFR mutation type, tumor stage and EGFR-TKI treatment

      Index methodIncluded studiesSensitivitySpecificityDORAUROR
      ddPCR1271.7% (95% CI, 67.6%-75.5%)96.4% (95% CI, 94.2%-97.9%)39.3 (95% CI, 21.2-73.1)0.87 (95% CI, 0.80-0.94)
      ARMS-PCR1665.3% (95% CI, 62.9%-67.6%)98.2% (95% CI, 97.6%-98.7%)52.8 (95% CI, 26.3-106.1)0.71 (95% CI, 0.52-0.91)
      Subgroup analysis of exon 19 deletion in two systems
      ddPCR973.2% (95% CI, 67.0%-78.7%)99.3% (95% CI, 98.2%-99.8%)170.8 (95% CI, 77.8-374.8)0.97 (95% CI, 0.92-1.00)
      ARMS-PCR1166.3% (95% CI, 60.9%-71.3%)99.3% (95% CI, 98.6%-99.7%)113.7 (95% CI, 39.9-323.4)0.65 (95% CI, 0.25-1.00)
      Subgroup analysis of L858R in two systems
      ddPCR1068.4% (95% CI, 61.7%-74.7%)98.8% (95% CI, 97.6%-99.5%)108.8 (95% CI, 55.3-214.3)0.97 (95% CI, 0.92-1.00)
      ARMS-PCR1161.6% (95% CI, 54.9%-68.0%)99.3% (95% CI, 98.7%-99.7%)110.1 (95% CI, 49.7-243.8)0.79 (95% CI, 0.42-1.00)
      Subgroup analysis of stage IIIB-IV and recurrence in two systems
      ddPCR472.5% (95% CI, 65.8%-78.6%)93.5% (95% CI, 89.1%-96.5%)35.1 (95% CI, 17.9-68.8)0.90 (95% CI, 0.82-1.00)
      ARMS-PCR573.7% (95% CI, 66.7%-79.8%)96.3% (95% CI, 92.1%-98.6%)52.1 (95% CI, 7.0-387.7)0.52 (95% CI, 0.00-1.00)
      Subgroup analysis of stage IA-IV in two systems
      ddPCR871.2% (95% CI, 65.8%-76.1%)98.8% (95% CI, 96.4%-99.7%)46.8 (95% CI, 16.1-136.5)0.88 (95% CI, 0.70-1.00)
      ARMS-PCR1164.2% (95% CI, 61.7%-66.7%)98.3% (95% CI, 97.7%-98.8%)60.7 (95% CI, 30.9-119.2)0.77 (95% CI, 0.55-0.99)
      Subgroup analysis of TKI-naive in two systems
      ddPCR571.7% (95% CI, 65.4%-77.4%)96.5% (95% CI, 93.9%-98.2%)51.9 (95% CI, 24.8-108.7)0.90 (95% CI, 0.81-0.99)
      ARMS-PCR563.9% (95% CI, 57.4%-70.1%)96.7% (95% CI, 94.1%-98.4%)41.9 (95% CI, 9.6-183.6)0.60 (95% CI, 0.04-1.00)
      Subgroup analysis of previous-TKI in two systems
      ddPCR774.1% (95% CI, 68.2%-79.4%)95.4% (95% CI, 87.1%-99.0%)19.9 (95% CI, 5.8-68.9)0.84 (95% CI, 0.73-95.8)
      ARMS-PCR865.4% (95% CI, 62.8%-77.9%)98.5% (95% CI, 97.9%-99.0%)72.6 (95% CI, 25.6-205.7)0.75 (95% CI, 0.49-1.00)
      .

      fd69c5cf902969e6fb71d043085ddee6 Conclusions

      This study demonstrates that both ddPCR and ARMS-PCR have a high specificity with a practical sensitivity for detecting EGFR mutation in cfDNA of advanced lung cancer patients, which supports their application as a supplement or an alternative to tissue biopsy in clinical practice for genotyping.

      b651e8a99c4375feb982b7c2cad376e9 Legal entity responsible for the study

      The First Affiliated Hospital of Guangzhou Medical University.

      213f68309caaa4ccc14d5f99789640ad Funding

      Has not received any funding.

      682889d0a1d3b50267a69346a750433d Disclosure

      All authors have declared no conflicts of interest.

      cffcb1a185b2d7d5c44e9dc785b6bb25

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