Document Type: Research Articles
Division of Thoracic Cancer, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China.
Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China.
Backgrounds: Targeted therapy for lung cancer depends on the genetic testing. Liquid biopsy provides a valuable
source for the genetic testing. However, direct evidence was lacking for whether liquid biopsy could guide the targeted
therapy. Methods: In this retrospective study, the admitted patients from Jan 2015 to Feb 2016 were screened through
a pre-established database. Patients with metastatic, pathologically-confirmed, and treatment naïve non-small cell
lung cancer who were prescribed with epithelial growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) from
the guidance of liquid biopsy were enrolled (Liquid group). The mutation status in tumors was not mandatory. During
the same period, patients medicated with TKI based on tumor samples were included in the Control group. They were
enrolled in an age-, gender-, performance-, smoking-, and histology-matched manner. Results: We screened 536 patients
and enrolled 26 patients in the Liquid group. Another 26 patients were enrolled in a 1:1 ratio in the Control group.
In the Liquid group, a high consistence (84.6%) in EGFR mutation status between liquid and tumor was observed.
The best response was partial response in 19 patients (73.1 %), and followed by stable disease in 6 patients (23.1 %).
The median progression-free survival was 10.0 months (95%CI: 4.2-15.8 months). In the Control group, a similar disease
control rate (88.4%, P=0.603) and comparable PFS (8.6 months, 95% CI: 7.6-10.4 months, P=0.714, HR=0.657, 95%
CI: 0.309-1.396) was found. In the Liquid group, 3 of 4 patients with discordant results between tumor and liquid biopsy
showed treatment responses favoring the liquid biopsy. Conclusion: This study provided direct evidence supporting
the liquid biopsy for guiding the targeted therapy for lung cancer.