28 / 35
•
Several factors, including difficulty of repeat solid biopsy, frailty of
patients with more advanced disease, and higher ctDNA
concentrations after progression, render liquid biopsies a good
alternative
•
However,
validation of negative results is still needed
EGFR
Liquid Biopsy as an alternative to tissue at progression
Overall pooled accuracy of
ctDNA analysis:
•
Sensitivity = 0.67
•
Specificity = 0.80
Passiglia et al. Sci Rep. 2018;8:13379; Adapted form SEOM guidelines, Majem CTO 2018.
EGFR
mutation
Osimertinib
**
(I,A)
T790M+
Tissue
confirmation
T790M-
Liquid biopsy or tissue rebiopsy
Systemic progression