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Adding a blood test to routine practice nearly doubled the number of patients found to have a treatable mutation, and a third of those tested by blood alone were spared a biopsy.
A prospective cohort of 323 patients with metastatic non-small-cell lung cancer had plasma next-generation sequencing on a 73-gene platform ordered as part of routine clinical management. Therapeutically targetable mutations in EGFR, ALK, MET, BRCA1, ROS1, RET, ERBB2 or BRAF were detected in 113 patients overall, 35.0%. Ninety-four patients had plasma testing only, and a targetable mutation was found in 31 of them, 33.0%, sparing an invasive biopsy. Among the remaining 229 patients who had concurrent plasma and tissue testing or could not have tissue testing, a targetable mutation was detected in tissue alone for 47 patients, 20.5%, and the addition of plasma raised this to 82, 35.8%. Thirty-six of 42 patients treated on the basis of a plasma result achieved a complete or partial response or stable disease.
It showed the benefit of plasma testing is not only analytical but logistical: it reaches patients who are too unwell, or whose disease is too inaccessible, for a repeat biopsy.
Shares Biopsy, ROS1, Cell-free DNA (cfDNA), RET.
Shares Biopsy, ROS1, Cell-free DNA (cfDNA), RET.
Shares ROS1, RET, Next-generation sequencing (NGS), MET.
Shares Biopsy, Cell-free DNA (cfDNA), JAMA Oncology, MET.
Shares RET, MET, ALK, Comprehensive genomic profiling.
Shares Next-generation sequencing (NGS), MET, ALK, Receptor tyrosine kinase activation.