NSCLC: plasma-based NGS boosts detection of targetable mutations

  • JAMA Oncol

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
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Takeaway

  • Adding plasma-based next-generation sequencing (NGS) to tissue NGS significantly increased the detection of therapeutically targetable mutations in patients with NSCLC.

Why this matters

  • Detection of mutations via plasma testing avoids the need for invasive biopsies.

Study design

  • 323 patients with stage IV NSCLC.
  • 94 patients had plasma testing alone at physician or patient preference; 128 had concurrent plasma and tissue testing; and 101 had plasma testing alone because tissue testing was not possible.
  • Funding: National Institutes of Health and others.

Key results

  • Clinically relevant mutations were detected in tissue and/or plasma of 54.5% of patients, and 35.0% of patients had therapeutically targetable mutations.
  • 57.4% of patients had mutations detected in plasma only, 30.7% in concurrent plasma and tissue, and 11.9% in tissue only.
  • Of the 94 patients who had plasma testing by physician or patient preference, 33% had a therapeutically targetable mutation.
  • Of the remaining 229 patients, adding plasma testing to tissue NGS increased mutation detection from 20.5% to 35.8%.
  • Disease control, partial response, or stable disease after first-line therapy achieved in 85.7% of patients who received a targeted therapy based on mutations detected by plasma alone or concurrent plasma and tissue testing.

Limitations

  • Single-center study.

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