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JPTM > Ahead-of Print

doi: https://doi.org/10.4132/jptm.2019.02.22    [Epub ahead of print]
Provisional Guideline Recommendation for EGFR gene mutation Testing in Liquid Samples of Lung Cancer Patients: A Proposal by the Korean Cardiopulmonary Pathology Study Group
Dong Hoon Shin1, Hyo Sup Shim2, Tea Jung Kim3, Heae Surng Park4, Yun La Choi5, Wan Seop Kim6, Lucia Kim7, Sun Hee Chang8, Joon Seon Song9, Hyo jin Kim10, Jung Ho Han5, Chang Hun Lee1, Geon Kook Lee11, Se Jin Jang9, Korean Cardiopulmonary Pathology Study Group
1Department of Pathology, Pusan National University College of Medicine, Yangsan, Korea
2Department of Pathology, Yonsei University College of Medicine, Seoul, Korea
3Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul, Korea
4Department of Pathology, Ewha Womans University Mokdong Hospital, Seoul, Korea
5Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
6Departments of Pathology, Konkuk University School of Medicine, Seoul, Korea
7Department of Pathology, Inha University School of Medicine, Incheon, Korea
8Department of Pathology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
9Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
10Department of Pathology, Seoul National University Bundang Hospital, Seongnam, Korea
11Department of Pathology, National Cancer Center, Goyang, Korea
Corresponding Author: Se Jin Jang ,Email: jangsejin@amc.seoul.kr
Received: November 29, 2018;  Revised: February 7, 2019  Accepted: February 20, 2019.  Published online: February 28, 2019.
Liquid biopsy for detection of mutation from circulating tumor DNA (ctDNA) is a new technology which is attractive in that it is non-invasive. Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKI) is an effective first line drug for advanced non-small cell lung cancer (NSCLC) patients who harbor activating EGFR mutation. During the course of treatment, resistance against TKI arises which can be contributed to EGFR T790M mutation in about 50-60% of patients. Third generation TKI may overcome the resistance. In patients who cannot undergo tissue biopsy due to variable reasons, liquid biopsy is an excellent alternative for the detection of EGFR T790M mutation. However, this relatively novel method requires standardization, and vigorous quality insurance. Thus, a standard set of guideline recommendations for liquid biopsy for EGFR mutation testing suitable for the Korean medical community is necessary. In this article, we propose a set of provisional guideline recommendations that was discussed and approved by the Cardiopulmonary Pathology Study Group of the Korean Society of Pathologists.
Key Words: Carcinoma, non-small cell lung; Epidermal growth factor receptor; T790M; Circulating tumor DNA; Liquid biopsy