Received: January 9, 2018 Revision received: January 25, 2018 Accepted after revision: January 30, 2018
BKK Med J 2018;14(1):5-9.
Non-small cell lung cancer (NSCLC) remains the leading cause of cancer-related deaths among Asian population. Liquid biopsy is a new technology that provides information on tumor gene profiling through examination of cell-free DNA (CfDNA) in whole blood. This produces data on genetic alterations found in tumor tissue that could be used for prompt and effective management of NSCLC.
tween September 2016 and December 2016, we retrospectively collected and reviewed the medical records of thirty-five patients who were suspected or diagnosed of lung cancer, then underwent serum epidermal growth factor receptor (EGFR) for further investigation. Liquid biopsy results were compared with the subjects’ final diagnosis.
The final diagnoses revealed eighteen (51%) benign and seventeen (49%) malignant cases. Fourteen out of seventeen malignant cases were diagnosed as adenocarcinoma. The remaining three out of seventeen subjects’ diagnoses were: anaplastic giant cell, carcinoid tumor and thyroid cancer with lung metastasis. These three were considered as true negative for EGFR liquid biopsy results. The fourteen malignant cases were divided into two categories which were surgical and chemotherapy or TKI groups. In the surgical group, five were positive for tissue EGFR mutation followed by a negative serum EGFR results post-surgery. One out of the five cases reported negative serum EGFR just four days post-operatively.
In the chemotherapy or tyrosine kinase inhibitor (TKI) group, four out of nine were tested prior to treatment with three positive results. One was negative serum EGFR but had positive tissue EGFR. One case out of nine reported positive EGFR followed by a negative EGFR at thirteen days while on treatment. The last four subjects were tested during prolonged treatment. Two from the four cases reported negative results. One detected resistance and the last case was negative EGFR but later deteriorated.
Liquid biopsy’s roles include lung cancer screening, treatment evaluation, assessment of recurrence or resistance, an alternative for tissue biopsy and a complementary blood test with radiographic imaging. This test substantially improves patient care and outcomes at all stages of lung cancer.
lung cancer diagnosis, non-small cell lung cancer, liquid biopsy, epidermal growth factor receptor
Sawang Saenghirunvattana, MD
Chest Center, Bangkok Hospital Headqaurters
2 Soi Soonvijai 7, New Petchburi Rd., Bangkok 10310, Thailand.