The diagnostic accuracy of circulating tumor DNA for the detection of EGFR-T790M mutation in NSCLC: a systematic review and meta-analysis

This pooled analysis aims at evaluating the diagnostic accuracy of circulating tumor (ct) DNA for the detection of EGFR-T790M mutation in NSCLC patients who progressed after EGFR-TKIs. Data from all published studies, reporting both sensitivity and specificity of plasma-based EGFR-T790M mutation tes...

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Published in:Scientific reports 2018-09, Vol.8 (1), p.13379-10, Article 13379
Main Authors: Passiglia, Francesco, Rizzo, Sergio, Di Maio, Massimo, Galvano, Antonio, Badalamenti, Giuseppe, Listì, Angela, Gulotta, Leonardo, Castiglia, Marta, Fulfaro, Fabio, Bazan, Viviana, Russo, Antonio
Format: Article
Language:English
Subjects:
631/67/1857
692/4028/67/1612/1350
Deoxyribonucleic acid
DNA
Epidermal growth factor receptors
Humanities and Social Sciences
Lung cancer
Meta-analysis
multidisciplinary
Mutation
Non-small cell lung carcinoma
Science
Science (multidisciplinary)
Systematic review
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Summary:This pooled analysis aims at evaluating the diagnostic accuracy of circulating tumor (ct) DNA for the detection of EGFR-T790M mutation in NSCLC patients who progressed after EGFR-TKIs. Data from all published studies, reporting both sensitivity and specificity of plasma-based EGFR-T790M mutation testing by ctDNA were collected by searching in PubMed, Cochrane Library, American Society of Clinical Oncology, European Society of Medical Oncology and World Conference of Lung Cancer meeting proceedings. A total of twenty-one studies, with 1639 patients, were eligible. The pooled sensitivity of ctDNA analysis was 0.67 (95% CI: 0.64–0.70) and the pooled specificity was 0.80 (95% CI: 0.77–0.83). The pooled positive predictive value (PPV) was 0.85 (95% CI: 0.82–0.87) and the pooled negative predictive value (NPV) was 0.60 (95% CI: 0.56–0.63). The positive likelihood ratio (PLR) and negative likelihood ratio (NLR) were 2.67 (95% CI: 1.86–3.82) and 0.46 (95% CI: 0.38–0.54), respectively. The pooled diagnostic odds ratio (DOR) was 7.27 (4.39–12.05) and the area under the curve (AUC) of the summary receiver operating characteristics (sROC) curve was 0.77. The ctDNA analysis represents a promising, non-invasive approach to detect and monitor the T790M mutation status in NSCLC patients. Development of standardized methodologies and clinical validation are recommended.
ISSN:2045-2322
2045-2322
DOI:10.1038/s41598-018-30780-4