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Masago K, Fujita S, Hata A, Okuda C, Yoshizumi Y, Kaji R, Katakami N, Hirata Y, Yatabe Y. Validation of the digital PCR system in tyrosine kinase inhibitor-resistant EGFR
mutant non-small-cell lung cancer. Pathol Int 2018; 68:167-173. [DOI: 10.1111/pin.12630] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 12/07/2017] [Indexed: 12/30/2022]
Affiliation(s)
- Katsuhiro Masago
- Department of Pathology and Molecular Diagnostics; Aichi Cancer Center; Aichi Japan
- Division of Integrated Oncology; Institute of Biomedical Research and Innovation; Kobe Japan
| | - Shiro Fujita
- Department of Pathology and Molecular Diagnostics; Aichi Cancer Center; Aichi Japan
- Division of Integrated Oncology; Institute of Biomedical Research and Innovation; Kobe Japan
| | - Akito Hata
- Division of Integrated Oncology; Institute of Biomedical Research and Innovation; Kobe Japan
| | - Chiyuki Okuda
- Division of Integrated Oncology; Institute of Biomedical Research and Innovation; Kobe Japan
| | - Yuko Yoshizumi
- Division of Integrated Oncology; Institute of Biomedical Research and Innovation; Kobe Japan
| | - Reiko Kaji
- Division of Integrated Oncology; Institute of Biomedical Research and Innovation; Kobe Japan
| | - Nobuyuki Katakami
- Division of Integrated Oncology; Institute of Biomedical Research and Innovation; Kobe Japan
| | - Yukio Hirata
- Division of Integrated Oncology; Institute of Biomedical Research and Innovation; Kobe Japan
| | - Yasushi Yatabe
- Department of Pathology and Molecular Diagnostics; Aichi Cancer Center; Aichi Japan
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Masago K, Fujita S, Muraki M, Hata A, Okuda C, Otsuka K, Kaji R, Takeshita J, Kato R, Katakami N, Hirata Y. Next-generation sequencing of tyrosine kinase inhibitor-resistant non-small-cell lung cancers in patients harboring epidermal growth factor-activating mutations. BMC Cancer 2015; 15:908. [PMID: 26572169 PMCID: PMC4647703 DOI: 10.1186/s12885-015-1925-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 11/11/2015] [Indexed: 02/08/2023] Open
Abstract
Background The aim of this study was to detect the epidermal growth factor receptor (EGFR)-activating mutations and other oncogene alterations in patients with non-small-cell lung cancers (NSCLC) who experienced a treatment failure in response to EGFR-tyrosine kinase inhibitors (TKIs) with a next generation sequencer. Methods Fifteen patients with advanced NSCLC previously treated with EGFR-TKIs were examined between August 2005 and October 2014. For each case, new biopsies were performed, followed by DNA sequencing on an Ion Torrent Personal Genome Machine (PGM) system using the Ion AmpliSeq Cancer Hotspot Panel version 2. Results All 15 patients were diagnosed with NSCLC harboring EGFR-activating mutations (seven cases of exon 19 deletion, seven cases of L858R in exon 21, and one case of L861Q in exon 21). Of the 15 cases, acquired T790M resistance mutations were detected in 9 (60.0 %) patients. In addition, other mutations were identified outside of EGFR, including 13 cases (86.7 %) exhibiting TP53 P72R mutations, 5 cases (33.3 %) of KDR Q472H, and 2 cases (13.3 %) of KIT M541L. Conclusions Here, we showed that next-generation sequencing (NGS) is able to detect EGFR T790M mutations in cases not readily diagnosed by other conventional methods. Significant differences in the degree of EGFR T790M and other EGFR-activating mutations may be indicative of the heterogeneity of disease phenotype evident within these patients. The co-existence of known oncogenic mutations within each of these patients may play a role in acquired EGFR-TKIs resistance, suggesting the need for alternative treatment strategies, with PCR-based NGS playing an important role in disease diagnosis.
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Affiliation(s)
- Katsuhiro Masago
- Division of Integrated Oncology, Institute of Biomedical Research and Innovation, 2-2 Minatojima-minamimachi, Cyuo-ku, Kobe City, Hyogo, 650-0047, Japan.
| | - Shiro Fujita
- Division of Integrated Oncology, Institute of Biomedical Research and Innovation, 2-2 Minatojima-minamimachi, Cyuo-ku, Kobe City, Hyogo, 650-0047, Japan.
| | | | - Akito Hata
- Division of Integrated Oncology, Institute of Biomedical Research and Innovation, 2-2 Minatojima-minamimachi, Cyuo-ku, Kobe City, Hyogo, 650-0047, Japan.
| | - Chiyuki Okuda
- Division of Integrated Oncology, Institute of Biomedical Research and Innovation, 2-2 Minatojima-minamimachi, Cyuo-ku, Kobe City, Hyogo, 650-0047, Japan.
| | - Kyoko Otsuka
- Division of Integrated Oncology, Institute of Biomedical Research and Innovation, 2-2 Minatojima-minamimachi, Cyuo-ku, Kobe City, Hyogo, 650-0047, Japan.
| | - Reiko Kaji
- Division of Integrated Oncology, Institute of Biomedical Research and Innovation, 2-2 Minatojima-minamimachi, Cyuo-ku, Kobe City, Hyogo, 650-0047, Japan.
| | - Jumpei Takeshita
- Division of Integrated Oncology, Institute of Biomedical Research and Innovation, 2-2 Minatojima-minamimachi, Cyuo-ku, Kobe City, Hyogo, 650-0047, Japan.
| | - Ryoji Kato
- Division of Integrated Oncology, Institute of Biomedical Research and Innovation, 2-2 Minatojima-minamimachi, Cyuo-ku, Kobe City, Hyogo, 650-0047, Japan.
| | - Nobuyuki Katakami
- Division of Integrated Oncology, Institute of Biomedical Research and Innovation, 2-2 Minatojima-minamimachi, Cyuo-ku, Kobe City, Hyogo, 650-0047, Japan.
| | - Yukio Hirata
- Division of Integrated Oncology, Institute of Biomedical Research and Innovation, 2-2 Minatojima-minamimachi, Cyuo-ku, Kobe City, Hyogo, 650-0047, Japan.
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Rangachari D, VanderLaan PA, Le X, Folch E, Kent MS, Gangadharan SP, Majid A, Haspel RL, Joseph LJ, Huberman MS, Costa DB. Experience with targeted next generation sequencing for the care of lung cancer: insights into promises and limitations of genomic oncology in day-to-day practice. ACTA ACUST UNITED AC 2015; 4:174-181. [PMID: 26601054 DOI: 10.1016/j.ctrc.2015.10.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Tumor genotyping using single gene assays (SGAs) is standard practice in advanced non-small-cell lung cancer (NSCLC). We evaluated how the introduction of next generation sequencing (NGS) into day-to-day clinical practice altered therapeutic decision-making. METHODS Clinicopathologic data, tumor genotype, and clinical decisions were retrospectively compiled over 6 months following introduction of NGS assay use at our institution in 82 patient-tumor samples (7 by primary NGS, 22 by sequential SGAs followed by NGS, and 53 by SGAs). RESULTS SGAs identified abnormalities in 34 samples, and all patients with advanced EGFR-mutated or ALK-rearranged tumors received approved tyrosine kinase inhibitors (TKIs) or were consented for clinical trials. NGS was more commonly requested for EGFR, ALK, and KRAS-negative tumors (p<0.0001). NGS was successful in 24/29 (82.7%) tumors. Of 17 adenocarcinomas (ACs), 11 (7 from patients with ≤15 pack-years of smoking) had abnormalities in a known driver oncogene. This led to a change in decision-making in 8 patients, trial consideration in 6, and off-label TKI use in 2. Of 7 squamous cell (SC) carcinomas, 1 had a driver aberration (FGFR1); 6 had other genomic events (all with TP53 mutations). In no cases were clinical decisions altered (p=0.0538 when compared to ACs). CONCLUSIONS Targeted NGS can identify a significant number of therapeutically-relevant driver events in lung ACs; particularly in never or light smokers. For SC lung cancers, NGS is less likely to alter current practice. Further research into the cost effectiveness and optimal use of NGS and improved provider training in genomic oncology are warranted.
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Affiliation(s)
- Deepa Rangachari
- Department of Medicine, 330 Brookline Avenue, Boston, MA 02215, USA
| | - Paul A VanderLaan
- Department of Pathology, 330 Brookline Avenue, Boston, MA 02215, USA
| | - Xiuning Le
- Department of Medicine, 330 Brookline Avenue, Boston, MA 02215, USA
| | - Erik Folch
- Department of Medicine, 330 Brookline Avenue, Boston, MA 02215, USA ; Department of Surgery, 330 Brookline Avenue, Boston, MA 02215, USA; all at Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Michael S Kent
- Department of Surgery, 330 Brookline Avenue, Boston, MA 02215, USA; all at Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Sidharta P Gangadharan
- Department of Surgery, 330 Brookline Avenue, Boston, MA 02215, USA; all at Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Adnan Majid
- Department of Medicine, 330 Brookline Avenue, Boston, MA 02215, USA ; Department of Surgery, 330 Brookline Avenue, Boston, MA 02215, USA; all at Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Richard L Haspel
- Department of Pathology, 330 Brookline Avenue, Boston, MA 02215, USA
| | - Loren J Joseph
- Department of Pathology, 330 Brookline Avenue, Boston, MA 02215, USA
| | - Mark S Huberman
- Department of Medicine, 330 Brookline Avenue, Boston, MA 02215, USA
| | - Daniel B Costa
- Department of Medicine, 330 Brookline Avenue, Boston, MA 02215, USA
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