149P - The role of CTCs and cfDNA for diagnosis and monitoring of EGFR mutations in advanced NSCLC patients

Date 15 April 2016
Event European Lung Cancer Conference 2016 (ELCC) 2016
Session Poster lunch
Topics Translational Research
Non-small-cell lung cancer
Basic Principles in the Management and Treatment (of cancer)
Presenter Silvia Calabuig-Fariñas
Citation Journal of Thoracic Oncology (2016) 11 (supplement 4): S57-S166. S1556-0864(16)X0004-4
Authors S. Calabuig-Fariñas1, E. Jantus Lewintre2, C. Mayo-De-Las-Casas3, A. Blasco Cordellat4, M.A. Molina-Vila3, R. Rosell5, C. Camps6
  • 1Department Of Pathology, Universitat De València, Molecular Oncology Laboratory, General University Hospital Research Foundation, 46014 - Valencia/ES
  • 2Department Of Biotechnology, Universidad Politécnica De Valencia, Molecular Oncology Laboratory, General University Hospital Research Foundation, Valencia/ES
  • 3Laboratory Of Oncology/pangaea Biotech S.l, Hospital Quiron Dexeus, Barcelona/ES
  • 4Servicio De Oncologia Medica, Hospital General Universitario Valencia, 46018 - Valencia/ES
  • 5Translational Cancer Research Unit, Instituto Oncológico Dr.rosell, Quirón Dexeus University Hospital, Catalan Institute of Oncology, Hospital Germans Trias i Pujol Badalona, Barcelona/ES
  • 6Department Of Medicine, Universitat De València, Department Of Medical Oncology, Hospital General Universitario Valencia, Molecular Oncology Laboratory, General University Hospital Research Foundation, Valencia/ES



Liquid biopsies are novel options for analysis of biomarkers offering valuable prognostic and predictive information. Recent studies suggest that CTCs (Circulating Tumor Cells) and cfDNA (circulating free DNA) analysis allows a non-invasive diagnosis and treatment monitoring. The aim of this study was to correlate the EGFR mutational status in both CTCs as cfDNA at diagnosis and during follow-up with the outcome in non-small-cell lung cancer (NSCLC) patients.


Blood samples were collected from 16 advanced NSCLC patients, and repeated sampling was performed during follow-up and at progression. CTCs were isolated by size using a filtration-based device (ScreenCell), characterized and enumerated by H&E; whereas cfDNA was obtained from plasma. CTC and cfDNA genotyping was performed by PNA-Taqman assay for EGFR 19del, L858R and T790M detection.


16 patients with advanced NSCLC harboring EGFR mutations in tumor were enrolled in the study. Median age of the cohort was 65 years; 81% were female, 81% never-smokers, 94% were ADC. The follow-up ranged from 3 to 48 months. All patients were treated with EGFR-TKIs. A total of 12 and 37 blood samples were collected at baseline and during follow-up, respectively. CTCs ranged from 1–30/3 ml of blood. The detection of EGFR mutation can provide early information about outcome: early undetectable mutations after EGFR-TKI might predict a large clinical response, whereas in TKI-responders, EGFR mutation remained undetectable in both CTCs and cfDNA, and its reappearance preceded disease progression. In one case, where the mutation in blood persisted during treatment, a rapid progression was observed followed by the exitus of the patient. These results suggest that monitoring of EGFR-mutational status in cfDNA or CTCs during TKI-treatment could provide important information regarding response to treatment or resistance mechanisms.


CTC and cfDNA are promising source for biomarker's tests and useful tools for the management of patients with advanced NSCLC; although there is a need to validate and standardize these type of methodological approaches. This work was supported in part, by Astra Zeneca (ISSIRES0110) and López-Trigo Grant.

Clinical trial identification

Legal entity responsible for the study

Universitat de València.


Astra Zeneca (ISSIRES0110)


All authors have declared no conflicts of interest.