The concomitant co-mutation with epidermal growth factor receptor (EGFR) mutation might influence the clinical outcomes. The investigators will identify the impact of concommitant mutation on clinical outcome in patients with advanced -EGFR mutated adenocarcinoma. The investigators will compare the genetic alterations between tumors of pre and post Tyrosin Kinase Inhibitor(TKI) treatments and predict the resistance mechanism for EGFR-TKIs by next-generation sequencing(NGS) analysis.
The current standard therapies in the treatment of advanced EGFR-mutated lung cancer patients are the 1st or 2nd EGFR-TKIs. Although 70-80% of patients treated by EGFR-TKIS show good responses, they have progression after around 12 months. The concomitant co-mutation with EGFR mutation might influence the drug response of EGFR TKI. The investigators will compare the progression-free survival (PFS) of EGFR-TKI according to co-occuring mutations. The patients experience the change of molecular profiles after using the TKI. Therefore, the investigators will investigate the molecular profiles through NGS panel with foundation medicine in the tissue of pre/post EGFR-TKI, compare the change of the molecular profiles and tumor mutation burden(TMB), and identify novel mechanisms of drug resistance. The investigators will collect the tumor tissues and blood of around 80 patients in multi-centers prospectively. Then, They will be sent to FoundationOne in the US and perform NGS analysis. The type of EGFR-TKIs would be selected according to physicians' preference. NGS will be performed twice before the EGFR-TKIs treatment and after the progression.
Study Type
OBSERVATIONAL
Enrollment
80
observational study
Asan medical center
Seoul, South Korea
RECRUITINGCatholic university medical center, Seoul St. Mary's Hospital
Seoul, South Korea
NOT_YET_RECRUITINGChange of mutation profiles between pre/post TKI treatment
Comparison of the kinds of the mutation between pre- and post TKI treatment
Time frame: through study completion, an average of 1 year
PFS according to the co-occurring mutations with pre-TKI treatment
The investigators will compared the PFS according to the kinds of co-occuring genetic alteration in patient with EGFR -mutated adenocarcinoma before the EGFR TKI treatment
Time frame: through study completion, an average of 1 year
The number and the kinds of co-occurring mutations on tumors before and after TKI treatment
The investigators will collect the information about the number and the kinds of co-occurring mutations on tumors before and after TKI treatment in Foundation medicine NGS
Time frame: through study completion, an average of 1 year
The correlation between the change of variant allele frequency(VAF) and drug response in matched tumors tissues before and after TKI treatment
The investigators will analyze the correlation with the change of the VAF and PFS in matched tumors tissues before and after TKI treatment
Time frame: through study completion, an average of 1 year
Tumor mutation burden in tumors tissues before and after TKI treatment
The investigators will compare the TMB in tumors tissues before and after TKI
Time frame: through study completion, an average of 1 year
The concordance the the mutation profiles in the NGS results of tissue and blood in the same patients
The investigators will compare the concordance of the mutation profile in tumors and blood before TKI treatment
Time frame: through study completion, an average of 1 year
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.