A comprehensive next generation sequencing approach identifies lung cancer-related genomic alterations. Detection of NCCN recommended genes and other lung cancer targeted and drug related genes, the assay provides biomarker information to guide personalized medication use for lung cancer patients.
In addition to the routine recommendation to detect EGFR and ALK gene mutation, BRAF, MET, RET, ROS1, HER2 gene variants are also listed in the NATIONAL COMPREHENSIVE CANCER NETWORK as emerging target detection for non-small cell lung cancer. In 2017 PD-L1, ROS1 was incorporated into the NCCN guidelines and suggested a wider range of genetic testing.
After several splitting proliferation, the daughter of tumor cells showing a molecular biology or genetic changes, leading tumor growth rate, invasive ability, sensitivity to the drug, prognosis and etc., differences. As a new tumor marker in the monitoring of the dynamic development of the tumor，ctDNA has a higher sensitivity and specificity, and can be better than the protein markers and imaging predict the dynamic development of the tumor. So ctDNA can be used for cancer early diagnosis, monitoring cancer development process, prognosis and individualized medication guidance.
One patient carrying EGFR 19DEL and T790M mutation after osimertinib treatment, plasma ctDNA mutation disappeared and CT showed significant tumor shrinkage.After 6 weeks of targeted treatment, ctDNA was almost difficult to detect, suggesting that the ctDNA can predict the therapeutic effect early first 6 weeks.
NCCN recommended detection gene marked as red
Lung Cancer somatic mutation marked as white
MSI gene marked as blue
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1. Mok et al, 2009, N Engl J Med.
2. llée A., et al. Lung Cancer; 2016, 91:73–74.
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