%0 Journal Article
%T Liquid Biopsy to Identify Actionable Genomic Alterations
%A Misako Nagasaka
%A Sai-Hong Ignatius Ou
%A Viola W. Zhu
%J About the Ed Book | ASCO Educational Book
%D 2018
%R https://doi.org/10.1200/EDBK_199765
%X The use of liquid biopsy (primarily from blood) in solid malignancy provides a convenient and safe way to detect the presence of actionable driver mutations, to assess the resistance mechanisms to actionable driver mutations, to monitor treatment response, to detect early recurrence, to serve as an adjuvant to radiologic imaging as post-treatment surveillance, and to prognosticate the outcome of cancer treatment. Cell-free DNA, including ctDNA, circulating tumor cells, and exosomes containing tumor microRNAs can all be detected by liquid biopsy. The biologic nature of ctDNA, the various sequencing platforms used in liquid biopsy, and the various utilities of liquid biopsy have recently been expertly and comprehensively reviewed by Wan and colleagues.1 The many sequencing platforms used in liquid biopsy can be broadly summarized as nondigital, digital, and NGS. The performances of these individual platform have been reviewed extensively.2-10 However, only five liquid biopsy test kits are approved by government agencies. DETECTION OF SPECIFIC ACTIONABLE GENOMIC ALTERATIONS BY LIQUID BIOPSY Section: ChooseTop of pageAbstractDETECTION OF SPECIFIC ACT... <<USE OF LIQUID BIOPSY TO D...NEXT-GENERATION SEQUENCIN...USE OF LIQUID BIOPSY TO D...USE OF ctDNA IN LIQUID BI...SHEDDERS VERSUS NONSHEDDE...CONCLUSIONReferences Detection of Activating EGFR Mutations in Lung Cancer Cobas EGFR mutations test version 2 ( EGFR del 19, L858R, T790M). The Cobas test (Roche Molecular Diagnostics, Pleasonton, CA) is the only U.S. Food and Drug Administration (FDA)¨Capproved liquid biopsy to detect the two most common activating epidermal growth factor receptor (EGFR) mutations (EGFR del19 and EGFR L858R) for the selection of EGFR tyrosine kinase inhibitor. It was subsequently approved for the detection of the most common acquired resistance mutation, EGFR T790M, after progression with first- or second-generation EGFR tyrosine kinase inhibitors for selection of osimertinib to treat patients with EGFR T790M¨Cpositive non¨Csmall cell lung cancer (NSCLC; Table 1).11-14 ENSURE, a randomized phase III trial comparing erlotinib to platinum/gemcitabine chemotherapy as first-line treatment of EGFR-positive NSCLC provided the basis for the approval of detection of EGFR del19 and EGFR L858R.15 Additional large-scale real-life prospective trials (ASSESS, Europe and Japan; and IGNITE, Russia and China/South Korea/Taiwan) studying the feasibility and testing the concordance of using Cobas liquid biopsy versus tumor have been completed.16,17 In the IGNITE study, the concordance between 2,561
%U http://ascopubs.org/doi/full/10.1200/EDBK_199765