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Bai B, An X, Qu Q, Liu X, Liu Y, Wei L. The clinical features and prognostic implications of the co-mutated TP53 gene in advanced non-small cell lung cancer. Clin Transl Oncol 2024:10.1007/s12094-024-03533-1. [PMID: 38872053 DOI: 10.1007/s12094-024-03533-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 05/18/2024] [Indexed: 06/15/2024]
Abstract
BACKGROUND TP53 is a frequently mutated oncogene within non-small cell lung cancer (NSCLC). However, the clinical and prognostic significance of co-mutations in TP53 in patients with advanced NSCLC has not been fully elucidated. METHODS A total of 174 patients with advanced NSCLC were enrolled in this study. All patients were subjected to sequencing analysis of tumor-related genes and information such as PD-L1 expression, TMB, and co-mutation changes were collected. Patients were categorized into TP53 mutant and TP53 wild-type groups according to their TP53 mutation status and then statistically analyzed. RESULTS TP53 mutations were the most common among all patients, accounting for 56.32%, followed by epidermal growth factor receptor mutations at 48.27%. The most common mutation sites in the TP53 mutation group were exons 5-8.TP53 mutations were significantly associated with PD-L1 and TMB levels. Univariate Cox analysis showed that gender and EGFR mutation affected the prognosis of TP53-mutated NSCLC patients, and multivariate Cox regression analysis identified EGFR mutation as an independent risk factor. The OS of NSCLC patients in the TP53 mutation group was significantly shorter than that of the TP53wt group. Survival curves in the TP53/EGFR combined mutation group showed that patients with combined EGFR mutation had a lower survival rate. DISCUSSION TP53 mutations are associated with different clinical indicators and have important implications in clinical treatment. TP53 is a poor prognostic factor for NSCLC patients, and TP53/EGFR co-mutation will affect the survival time of patients. TP53/EGFR co-mutation may be a new prognostic marker for NSCLC.
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Affiliation(s)
- Bing Bai
- Tai'an City Central Hospital (Tai'an Central Hospital Affiliated to Qingdao University, Mount Taishan Medical Center), Tai'an, 271000, Shandong, China
| | - Xia An
- Department of Respiratory Medicine, The Second Affiliated Hospital of Shandong First Medical University, No. 336 Taishan Street, Taishan District, Tai'an, 271000, Shandong, China
| | - Qinghui Qu
- Yutai County People's Hospital, Jining, 272300, Shandong, China
| | - Xin Liu
- Department of Respiratory Medicine, The Second Affiliated Hospital of Shandong First Medical University, No. 336 Taishan Street, Taishan District, Tai'an, 271000, Shandong, China.
| | - Yuanyuan Liu
- Department of Respiratory Medicine, The Second Affiliated Hospital of Shandong First Medical University, No. 336 Taishan Street, Taishan District, Tai'an, 271000, Shandong, China
| | - Li Wei
- Department of Respiratory Medicine, The Second Affiliated Hospital of Shandong First Medical University, No. 336 Taishan Street, Taishan District, Tai'an, 271000, Shandong, China
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Guo L, Zhou G, Huang M, Tang K, Xu J, Chen J. The impact of EGFR T790M mutation status following the development of Osimertinib resistance on the efficacy of Osimertinib in non-small cell lung cancer: A meta-analysis. THE CLINICAL RESPIRATORY JOURNAL 2024; 18:e13748. [PMID: 38584122 PMCID: PMC10999367 DOI: 10.1111/crj.13748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 01/19/2024] [Accepted: 03/12/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND Previous studies have suggested that loss of the EGFR T790M gene mutation may contribute to the development of resistance to Osimertinib in non-small cell lung cancer (NSCLC). AIMS This study aims to assess the relationship between the clinical effectiveness of Osimertinib in NSCLC patients and the T790M mutation status following resistance to Osimertinib and examine differences between plasma and tissue tests and between Asian and non-Asian groups. METHODS The PubMed, Web of Science, Cochrane, and EMBASE databases were comprehensively searched for studies on the association between T790M mutation status and the efficacy of Osimertinib between January 2014 and November 2023. Meta-analysis was carried out using Review Manager 5.4 software. RESULTS After evaluating 2727 articles, a total of 14 studies were included in the final analysis. Positive correlations between EGFR T790M mutation status after Osimertinib resistance and longer PFS (HR: 0.44, 95% CI: 0.30-0.66), longer OS (HR: 0.3, 95% CI: 0.10-0.86), longer TTD (HR: 0.69, 95% CI: 0.45-1.07), and improved clinical outcomes including PFS and TTD subgroups (HR: 0.58, 95% CI: 0.47-0.73) were observed. Subgroup analysis revealed that, compared with the blood tests, the results of the T790M mutation tests by the tissue are more significant (HR: 0.24, 95% CI: 0.11-0.52 for tissue tests; HR: 0.47, 95% CI: 0.22-1.00 for plasma tests), and the PFS of Osimertinib were similar for Asian and non-Asian patients (HR: 0.46, 95% CI: 0.31-0.68 for Asians; HR: 0.12, 95% CI: 0.01-1.27 for non-Asians). CONCLUSIONS Persistence of the T790M gene mutation after the development of Osimertinib resistance is associated with higher therapeutic benefits of Osimertinib in NSCLC patients. The results of tissue detection are more significant than those of plasma detection.
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Affiliation(s)
- Liuxian Guo
- Department of Pharmacy, The First Affiliated HospitalSun Yat‐sen UniversityGuangzhouChina
- School of Pharmaceutical Sciences, Sun Yat‐Sen University E‐132# Waihuandong RoadGuangzhou University CityGuangzhouChina
| | - Guojin Zhou
- Department of Pharmacy, The First Affiliated HospitalSun Yat‐sen UniversityGuangzhouChina
- School of Pharmaceutical Sciences, Sun Yat‐Sen University E‐132# Waihuandong RoadGuangzhou University CityGuangzhouChina
| | - Min Huang
- School of Pharmaceutical Sciences, Sun Yat‐Sen University E‐132# Waihuandong RoadGuangzhou University CityGuangzhouChina
| | - Kejing Tang
- Department of Pharmacy, The First Affiliated HospitalSun Yat‐sen UniversityGuangzhouChina
| | - Jing Xu
- Department of Pharmacy, Dermatology HospitalSouthern Medical UniversityGuangzhouChina
| | - Jie Chen
- Department of Pharmacy, The First Affiliated HospitalSun Yat‐sen UniversityGuangzhouChina
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Michaelidou K, Karniadakis I, Pantelaion V, Koutoulaki C, Boukla E, Folinas K, Dimaras P, Papadaki MA, Koutsopoulos AV, Mavroudis D, Vourlakou C, Mavridis K, Agelaki S. Rapid and reliable testing for clinically actionable EGFR mutations in non-small cell lung cancer using the Idylla TM platform: a real-world two-center experience in Greece. Expert Rev Mol Diagn 2024; 24:89-98. [PMID: 38193169 DOI: 10.1080/14737159.2024.2303320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 12/22/2023] [Indexed: 01/10/2024]
Abstract
BACKGROUND Limited information exists on epidermal growth factor receptor (EGFR) molecular epidemiology in Greece. Next-generation sequencing (NGS) is the recommended method for EGFR genotyping in NSCLC. The Idylla Biocartis platform is a fully automated system for actionable EGFR mutation detection. RESEARCH DESIGN AND METHODS We describe the prevalence of EGFR mutations in NSCLC patients in two high-volume clinical centers in Greece and compare key methods used for their determination. Eight hundred and fifty-seven FFPE samples from NSCLC patients were tested for EGFR mutations at University of Crete (UoC; n = 324) and at Evangelismos Hospital, Athens (Evangelismos; n = 503). RESULTS The prevalence of EGFR mutations was 11.1% in the whole cohort (11.5% in non-squamous). The detection rate was 11.0% by NGS, 9.8% by Sanger and 11.3% by Idylla for the whole cohort (12.0% in non-squamous). The agreement between Idylla and Sanger was 93.2%. A targetable EGFR mutation was detected in 10.0% using tissue NGS alone, and in 16.0% using concurrent Idylla ctEGFR testing. CONCLUSION The frequency of EGFR mutations was as expected for a Caucasian population. The Idylla EGFR test performance is comparable to reference methods and with a shorter TAT. Adding a concurrent plasma Idylla test to tissue NGS testing increases the detection rate of EGFR mutations in NSCLC.
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Affiliation(s)
- Kleita Michaelidou
- Laboratory of Translational Oncology, School of Medicine, University of Crete, Crete, Greece
| | - Ioannis Karniadakis
- Laboratory of Translational Oncology, School of Medicine, University of Crete, Crete, Greece
| | | | - Chara Koutoulaki
- Laboratory of Translational Oncology, School of Medicine, University of Crete, Crete, Greece
| | - Eleni Boukla
- Department of Medical Oncology, University General Hospital of Heraklion, Crete, Greece
| | | | - Pantelis Dimaras
- Department of Medical Oncology, University General Hospital of Heraklion, Crete, Greece
| | - Maria A Papadaki
- Laboratory of Translational Oncology, School of Medicine, University of Crete, Crete, Greece
| | | | - Dimitrios Mavroudis
- Laboratory of Translational Oncology, School of Medicine, University of Crete, Crete, Greece
- Department of Medical Oncology, University General Hospital of Heraklion, Crete, Greece
| | | | - Konstantinos Mavridis
- Institute of Molecular Biology and Biotechnology (IMBB), Foundation for Research and Technology-Hellas (FORTH), Heraklion, Crete, Greece
| | - Sofia Agelaki
- Laboratory of Translational Oncology, School of Medicine, University of Crete, Crete, Greece
- Department of Medical Oncology, University General Hospital of Heraklion, Crete, Greece
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Franzi S, Seresini G, Borella P, Raviele PR, Bonitta G, Croci GA, Bareggi C, Tosi D, Nosotti M, Tabano S. Liquid biopsy in non-small cell lung cancer: a meta-analysis of state-of-the-art and future perspectives. Front Genet 2023; 14:1254839. [PMID: 38116291 PMCID: PMC10728669 DOI: 10.3389/fgene.2023.1254839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 11/20/2023] [Indexed: 12/21/2023] Open
Abstract
Introduction: To date, tissue biopsy represents the gold standard for characterizing non-small-cell lung cancer (NSCLC), however, the complex architecture of the disease has introduced the need for new investigative approaches, such as liquid biopsy. Indeed, DNA analyzed in liquid biopsy is much more representative of tumour heterogeneity. Materials and methods: We performed a meta-analysis of 17 selected papers, to attest to the diagnostic performance of liquid biopsy in identifying EGFR mutations in NSCLC. Results: In the overall studies, we found a sensitivity of 0.59, specificity of 0.96 and diagnostic odds ratio of 24,69. Since we noticed a high heterogeneity among different papers, we also performed the meta-analysis in separate subsets of papers, divided by 1) stage of disease, 2) experimental design and 3) method of mutation detection. Liquid biopsy has the highest sensitivity/specificity in high-stage tumours, and prospective studies are more reliable than retrospective ones in terms of sensitivity and specificity, both NGS and PCR-based techniques can be used to detect tumour DNA in liquid biopsy. Discussion: Overall, liquid biopsy has the potential to help the management of NSCLC, but at present the non-homogeneous literature data, lack of optimal detection methods, together with relatively high costs make its applicability in routine diagnostics still challenging.
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Affiliation(s)
- Sara Franzi
- Thoracic Surgery and Lung Transplantation, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Gabriele Seresini
- Laboratory of Medical Genetics, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Paolo Borella
- Thoracic Surgery and Lung Transplantation, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Gianluca Bonitta
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Giorgio Alberto Croci
- Division of Pathology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Claudia Bareggi
- Medical Oncology Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Davide Tosi
- Thoracic Surgery and Lung Transplantation, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Mario Nosotti
- Thoracic Surgery and Lung Transplantation, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Silvia Tabano
- Laboratory of Medical Genetics, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
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