Liquid biopsy for monitoring EGFR-TKI drug resistance in patients with non-small-cell lung cancer

doi:10.3969/j.issn.1673-8640.2016.010.001

Abstract

Abstract:

As a milestone in the treatment of non-small-cell lung cancer,epidermal growth factor receptor （EGFR）-tyrosine kinase inhibitor（TKI） drugs significantly prolong the lifetime of patients with non-small-cell lung cancer and improve the patients' life quality. The frequency of EGFR mutation among non-small-cell lung cancer patients in Asia is higher than that among white men,so Asian patients have more benefits from EGFR-TKI drugs. However,one of the most important problems in targeted drugs is drug resistance. All EGFR-mutated patients who initially benefit from EGFR-TKI drugs develop progressive disease eventually,usually after approximately 1 year since treatment. Nowadays,due to drug resistance,there have been 3 generations of EGFR-TKI drugs. For the mechanisms of EGFR-TKI drug resistance,point mutation EGFR T790M and C797S are of special concern. Dynamic monitoring of drug resistance must be performed in patients who use EGFR-TKI drugs to achieve better therapeutic effect. Pathological biopsy is a gold standard for the diagnosis of cancer. However,pathological biopsy can not be competent for the dynamic monitoring of non-small-cell lung cancer patients,due to the risk of operation,the difficulty of getting tissue samples,being unable to determine in real-time,tumor heterogeneity and so on. Liquid biopsy is a new,non-invasive,convenient and highly reliable determination method. Liquid biopsy shows great potential on early diagnosis and screening,evaluation of therapeutic effect and prognosis and monitoring drug resistance by determing circulating tumor cell（CTC）,circulating tumor DNA（ctDNA）and tumor-released exosome in blood. This article reviews the progress of EGFR-TKI drugs and liquid biopsy,and assesses the potential of liquid biopsy in EGFR-TKI drug resistance of patients with non-small-lung cancer.

Key words: Liquid biopsy, Epidermal growth factor receptor, Tyrosine kinase inhibitor, Non-small-cell lung cancer

CLC Number:

R446.11

LIN Cheng, JIANG Tang. Liquid biopsy for monitoring EGFR-TKI drug resistance in patients with non-small-cell lung cancer[J]. Laboratory Medicine, 2016, 31(10): 835-843.

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