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Rebiopsy for patients with non‐small‐cell lung cancer after epidermal growth factor receptor‐tyrosine kinase inhibitor failure

Although third‐generation epidermal growth factor receptor‐tyrosine kinase inhibitors (EGFR‐TKI) can overcome T790M‐mediated resistance in non‐small‐cell lung cancer (NSCLC), rebiopsy to confirm T790M status is occasionally difficult. We aimed to investigate the current tendency and the limitations...

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Autores principales: Kawamura, Takahisa, Kenmotsu, Hirotsugu, Taira, Tetsuhiko, Omori, Shota, Nakashima, Kazuhisa, Wakuda, Kazushige, Ono, Akira, Naito, Tateaki, Murakami, Haruyasu, Mori, Keita, Nakajima, Takashi, Ohde, Yasuhisa, Endo, Masahiro, Takahashi, Toshiaki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4946719/
https://www.ncbi.nlm.nih.gov/pubmed/27145431
http://dx.doi.org/10.1111/cas.12963
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author Kawamura, Takahisa
Kenmotsu, Hirotsugu
Taira, Tetsuhiko
Omori, Shota
Nakashima, Kazuhisa
Wakuda, Kazushige
Ono, Akira
Naito, Tateaki
Murakami, Haruyasu
Mori, Keita
Nakajima, Takashi
Ohde, Yasuhisa
Endo, Masahiro
Takahashi, Toshiaki
author_facet Kawamura, Takahisa
Kenmotsu, Hirotsugu
Taira, Tetsuhiko
Omori, Shota
Nakashima, Kazuhisa
Wakuda, Kazushige
Ono, Akira
Naito, Tateaki
Murakami, Haruyasu
Mori, Keita
Nakajima, Takashi
Ohde, Yasuhisa
Endo, Masahiro
Takahashi, Toshiaki
author_sort Kawamura, Takahisa
collection PubMed
description Although third‐generation epidermal growth factor receptor‐tyrosine kinase inhibitors (EGFR‐TKI) can overcome T790M‐mediated resistance in non‐small‐cell lung cancer (NSCLC), rebiopsy to confirm T790M status is occasionally difficult. We aimed to investigate the current tendency and the limitations of rebiopsy in clinical practice. This study included 139 consecutive NSCLC patients with EGFR mutations, who had experienced progressive disease (PD) after EGFR‐TKI treatment. We retrospectively reviewed patient characteristics, tumor progression sites and rebiopsy procedures. Of 120 patients (out of the original 139) who were eligible for clinical trials, 75 (63%) underwent rebiopsy for 30 pleural effusions, 32 thoracic lesions, four bone, two liver, and seven at other sites. Rebiopsy procedures included 30 thoracocentesis, 24 transbronchial biopsies, 13 computed tomography (CT)‐guided needle biopsies and 8 other procedures. Of the 75 rebiopsied patients, 71 (95%) were pathologically diagnosed with malignancy; and 34 (45%) had available tissue samples for EGFR analyses. Of the 75 biopsied patients, 61 (81%) were analyzed for EGFR mutation, using tissue or cytology samples; T790M mutations were identified in 20 (33%) of the 61 patients. Of the 120 patients, 45 (38%) did not undergo rebiopsy, because of inaccessible tumor sites (n = 19), patient refusal (n = 6) or decision of physician (n = 10). In conclusion, among patients with EGFR mutations who had PD after EGFR‐TKI treatment, 63% underwent rebiopsy. Most rebiopsy samples were diagnosed with malignancy. However, tissue samples were less available and T790M mutations were identified less frequently than in previous studies. Skill and experience with rebiopsy and noninvasive alternative methods will be increasingly important.
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spelling pubmed-49467192016-07-27 Rebiopsy for patients with non‐small‐cell lung cancer after epidermal growth factor receptor‐tyrosine kinase inhibitor failure Kawamura, Takahisa Kenmotsu, Hirotsugu Taira, Tetsuhiko Omori, Shota Nakashima, Kazuhisa Wakuda, Kazushige Ono, Akira Naito, Tateaki Murakami, Haruyasu Mori, Keita Nakajima, Takashi Ohde, Yasuhisa Endo, Masahiro Takahashi, Toshiaki Cancer Sci Original Articles Although third‐generation epidermal growth factor receptor‐tyrosine kinase inhibitors (EGFR‐TKI) can overcome T790M‐mediated resistance in non‐small‐cell lung cancer (NSCLC), rebiopsy to confirm T790M status is occasionally difficult. We aimed to investigate the current tendency and the limitations of rebiopsy in clinical practice. This study included 139 consecutive NSCLC patients with EGFR mutations, who had experienced progressive disease (PD) after EGFR‐TKI treatment. We retrospectively reviewed patient characteristics, tumor progression sites and rebiopsy procedures. Of 120 patients (out of the original 139) who were eligible for clinical trials, 75 (63%) underwent rebiopsy for 30 pleural effusions, 32 thoracic lesions, four bone, two liver, and seven at other sites. Rebiopsy procedures included 30 thoracocentesis, 24 transbronchial biopsies, 13 computed tomography (CT)‐guided needle biopsies and 8 other procedures. Of the 75 rebiopsied patients, 71 (95%) were pathologically diagnosed with malignancy; and 34 (45%) had available tissue samples for EGFR analyses. Of the 75 biopsied patients, 61 (81%) were analyzed for EGFR mutation, using tissue or cytology samples; T790M mutations were identified in 20 (33%) of the 61 patients. Of the 120 patients, 45 (38%) did not undergo rebiopsy, because of inaccessible tumor sites (n = 19), patient refusal (n = 6) or decision of physician (n = 10). In conclusion, among patients with EGFR mutations who had PD after EGFR‐TKI treatment, 63% underwent rebiopsy. Most rebiopsy samples were diagnosed with malignancy. However, tissue samples were less available and T790M mutations were identified less frequently than in previous studies. Skill and experience with rebiopsy and noninvasive alternative methods will be increasingly important. John Wiley and Sons Inc. 2016-06-21 2016-07 /pmc/articles/PMC4946719/ /pubmed/27145431 http://dx.doi.org/10.1111/cas.12963 Text en © 2016 The Authors. Cancer Science published by John Wiley & Sons Australia, Ltd on behalf of Japanese Cancer Association. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs (http://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Articles
Kawamura, Takahisa
Kenmotsu, Hirotsugu
Taira, Tetsuhiko
Omori, Shota
Nakashima, Kazuhisa
Wakuda, Kazushige
Ono, Akira
Naito, Tateaki
Murakami, Haruyasu
Mori, Keita
Nakajima, Takashi
Ohde, Yasuhisa
Endo, Masahiro
Takahashi, Toshiaki
Rebiopsy for patients with non‐small‐cell lung cancer after epidermal growth factor receptor‐tyrosine kinase inhibitor failure
title Rebiopsy for patients with non‐small‐cell lung cancer after epidermal growth factor receptor‐tyrosine kinase inhibitor failure
title_full Rebiopsy for patients with non‐small‐cell lung cancer after epidermal growth factor receptor‐tyrosine kinase inhibitor failure
title_fullStr Rebiopsy for patients with non‐small‐cell lung cancer after epidermal growth factor receptor‐tyrosine kinase inhibitor failure
title_full_unstemmed Rebiopsy for patients with non‐small‐cell lung cancer after epidermal growth factor receptor‐tyrosine kinase inhibitor failure
title_short Rebiopsy for patients with non‐small‐cell lung cancer after epidermal growth factor receptor‐tyrosine kinase inhibitor failure
title_sort rebiopsy for patients with non‐small‐cell lung cancer after epidermal growth factor receptor‐tyrosine kinase inhibitor failure
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4946719/
https://www.ncbi.nlm.nih.gov/pubmed/27145431
http://dx.doi.org/10.1111/cas.12963
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