Work

Plasma-based next generation sequencing in advanced non-small cell lung cancer (NSCLC): significance in diagnosis and treatment in Asian patients

Year: 2025

Type: article

Abstract: NGS is recommended by NCCN and ESMO in evaluation of advanced NSCLC prior to treatment as being eligible for target therapy has important treatment implications. However, up to 20% of tissue biopsies are insufficient to run molecular testing for all nine FDA approved biomarkers. Currently, major guidelines recommend in the metastatic treatment naïve setting to pursue first line plasma-based NGS only if there is insufficient tissue. In our retrospective cohort, it was found that in 43 patients who underwent first line plasma-based and tissue NGS, 22 were Asians. Eleven of the twenty-two (50%) patients had an actionable mutation. The overwhelming majority of those mutations were EGFR actionable mutation (81.8%). All EGFR actionable mutations found on tissue was seen on plasma-based NGS, but 2 EGFR actionable mutation were seen on plasma-based NGS only. 22.2% of EGFR actionable mutations would have been missed if tissue-based NGS was pursued alone in the first line. In addition, in both plasma-based and tissue NGS, there is a statistically significant higher chance of detecting an EGFR actionable mutation if you were Asian compared to White (P = 0.004) or a nonsmoker compared to a smoker (P = 0.017). A small number of patients were found to have an EGFR actionable mutation on plasma-based NGS but not tissue NGS despite sufficient tissue to run NGS. They derived varying degrees of benefit from targeted therapy. Based on these findings patients who are Asian or nonsmoker plasma-based NGS should be considered in the diagnostic setting even if there is sufficient tissue for NGS.

Source: BMC Cancer

DOI: 10.1186/s12885-025-15295-2

Authors: Cherng-Horng Wu, Xia Wu, Xiao Hu, Alice Kennedy, Lori Pai

Institutions: Tufts Medical Center, Maine Medical Center, Maine Medical Center, Vanderbilt University Medical Center

Language: English

Topic: Lung Cancer Treatments and Mutations

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,390