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Clinical Utility of Target Selector™ ctDNA Testing: Detection of EGFR Mutations via Liquid Biopsy Enabled Targeted Therapy Selection for Patients with Advanced NSCLC

Veena M Singh, Rodrigo Erlich and Cecile Rose T Vibat

Background: Molecular profiling of tumors provides information key for devising personalized therapeutic strategies for managing disease in cancer patients. A liquid biopsy is emerging as a sensitive means to evaluate biomarker status without the complications and costs associated with surgical biopsies, particularly for patients unable or unwilling to undergo invasive procedures.
Materials and Methods: Patient blood specimens were collected in Biocept’s proprietary Blood Collection Tubes for liquid biopsy testing in Biocept’s CLIA-certified, CAP-accredited laboratory. Dual Circulating Tumor Cell (CTC) and circulating tumor DNA (ctDNA) platforms were utilized to detect ALK or ROS1 gene rearrangements by FISH, or EGFR mutations, respectively.
Results: Described are three metastatic NSCLC patients for which liquid biopsy guided the selection of a targeted therapy when a standard tissue biopsy was inadequate to assess biomarker status. All three patients were prescribed EGFR Tyrosine Kinase Inhibitor (TKI) treatment after an activating EGFR mutation was detected via liquid biopsy. One patient exhibited a complete response for approximately two years. Two patients received osimertinib following emergence of the EGFR T790M resistance mutation, which was also detected via a liquid biopsy.
Conclusion: Liquid biopsy analyses of ctDNA and CTCs can complement tumor testing, identifying potential drivers of a patient’s cancer. Clinical utility of liquid biopsy is demonstrated where the first line and subsequent targeted treatments were prescribed based on the identification of genomic alterations in blood. Each patient received a therapeutic benefit that significantly extended survival and enhanced their quality of life.