Abstract

Liquid biopsy has emerged as a minimally invasive alternative to tumor tissue analysis for the management of lung cancer patients, especially for epidermal growth factor receptor (EGFR) oncogene addicted tumor. In these patients, despite the clear benefits of tyrosine kinase inhibitors therapy, the development of acquired resistance and progressive disease is inevitable in most cases and liquid biopsy is important for molecular characterization at resistance and, being non-invasive, may be useful for disease monitoring. In this review, the authors will focus on the applications of liquid biopsy in EGFR-mutated non small cells lung cancer at diagnosis, during treatment and at progression, describing available data and possible future scenarios.

Highlights

  • Liquid biopsy consists in the analysis of tumor circulating materials derived from body fluids

  • Evaluation after first line therapy of epidermal growth factor receptor (EGFR)-mutant non small cells lung cancer (NSCLC) First-(gefitinib, erlotinib) and second-(afatinib, dacomitinib) generation EGFR tyrosine kinase inhibitors (TKIs) have been considered the standard first-line therapy for many years for EGFR mutant NSCLC but, even though the responses are generally solid and sustained, the onset of acquired resistance is universal and occurs mostly through on-target mechanisms (EGFR-dependent mechanisms) after a median of 9 to 12 months of treatment [9,10,11]. It is highly recommended for patients experiencing progressive disease (PD) during TKIs treatment to repeat a tissue biopsy at the progressing site to evaluate any potential mechanisms of resistance

  • Osimertinib is a third-generation EGFRTKI designed to target T790M positive (T790M+) EGFR in patients who have acquired this mechanism of resistance to earlier generation TKIs [6, 12]

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Summary

Open Access Review

Use of liquid biopsy in monitoring therapeutic resistance in EGFR oncogene addicted NSCLC.

Introduction
Clinical applications of liquid biopsy in EGFR oncogene addicted NSCLC
SCLC Mesenchymal transformation
On target Off target
Conclusion
Full Text
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