{"entity":{"id":"paper-krug-exosomal-rna-ctdna-egfr-ann-oncol-2018","kind":"paper","name":"Improved EGFR mutation detection using combined exosomal RNA and circulating tumor DNA in NSCLC patient plasma","aka":[],"tldr":"A lung cancer study that read EGFR mutations from vesicle RNA and cell-free DNA together, finding more mutations than from DNA alone, most of all in patients whose cancer sheds little.","summary":"In 84 patients, sensitivity was 98 per cent for activating EGFR mutations and 90 per cent for T790M with combined exosomal RNA and cell-free DNA, against 82 and 84 per cent for circulating tumour DNA by BEAMing. In patients with intrathoracic disease (M0/M1a, 21 patients), sensitivity rose from 26 to 74 per cent for activating mutations (P = 0.003) and from 19 to 31 per cent for T790M (P = 0.5).","asOf":"2026-11-04","links":[{"label":"Krug et al., Ann Oncol 2018","url":"https://doi.org/10.1093/annonc/mdx765"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/29216356/"}],"tags":[],"related":[],"cancers":["egfr-mutant-nsclc"],"sections":["diagnostics"],"technologies":["liquid-rna-biopsy","liquid-biopsy"],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":["ctdna"],"trials":[],"people":[],"bottlenecks":["b-subclone-attribution-residual-disease"],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"journal":"Annals of Oncology","year":2018,"doi":"10.1093/annonc/mdx765","pmid":"29216356","authors":"Krug AK, Enderle D, Karlovich C, et al.","paperType":"translational","findings":["Activating EGFR: 98% combined against 82% ctDNA alone.","Low-shedding subgroup: 26% to 74% (P = 0.003)."],"whatItMeans":"The clearest measured case that RNA from the same blood draw adds tumour signal where DNA runs short, though in advanced disease far above residual disease levels.","caveats":["Advanced cancer; sensitivity, not molecule counts; company authors."],"participants":84},"route":"/key-papers/paper-krug-exosomal-rna-ctdna-egfr-ann-oncol-2018/","neighbours":{"cancer":[{"id":"egfr-mutant-nsclc","kind":"cancer","name":"EGFR-mutated non-small-cell lung cancer","route":"/cancers/egfr-mutant-nsclc/"}],"section":[{"id":"diagnostics","kind":"section","name":"Diagnostics & Biomarkers","route":"/fronts/diagnostics/"}],"technology":[{"id":"liquid-biopsy","kind":"technology","name":"Liquid biopsy (ctDNA)","route":"/technologies/liquid-biopsy/"},{"id":"liquid-rna-biopsy","kind":"technology","name":"Liquid RNA biopsy (cell-free, vesicle and platelet RNA)","route":"/technologies/liquid-rna-biopsy/"}],"term":[{"id":"ctdna","kind":"term","name":"Circulating tumour DNA (ctDNA)","route":"/terms/ctdna/"}],"bottleneck":[{"id":"b-subclone-attribution-residual-disease","kind":"bottleneck","name":"Naming which clone or phenotype is left after treatment","route":"/bottlenecks/b-subclone-attribution-residual-disease/"}],"idea":[{"id":"idea-stack-ctdna-and-tumour-rna-residual-disease","kind":"idea","name":"Read tumour RNA and tumour DNA from the same blood draw to find and type residual cancer","route":"/ideas/idea-stack-ctdna-and-tumour-rna-residual-disease/"}]}}