Circulating Tumor DNA is Effective for the Detection of EGFR Mutation in Non-Small Cell Lung Cancer: A Meta-Analysis
A partir d'une revue de la littérature (27 études, 3 110 patients d'origine asiatique pour la plupart), cette méta-analyse montre que l'analyse de l'ADN tumoral circulant permet de détecter une mutation du gène EGFR chez les patients atteints d'un cancer du poumon non à petites cellules
Background : Circulating tumor DNA (ctDNA) has offered a minimally invasive and feasible approach for detect epidermal growth factor receptor (EGFR) mutation detection for non-small cell lung cancer (NSCLC). This meta-analysis was designed to investigate the diagnostic value of ctDNA, compared with current "gold standard", tumor tissues.
Methods : We searched PubMed, EMBASE, Cochrane Library, and Web of Science to identify eligible studies which reported the sensitivity and specificity of ctDNA for detection of EGFR mutation status in NSCLC. Eligible studies were pooled to calculate the pooled sensitivity, specificity, and diagnostic odds ratio (DOR). The summary receiver operating characteristic curve (SROC) and area under SROC (AUSROC) were used to evaluate the overall diagnostic performance.
Results : 27 eligible studies involving 3110 participants were included and analyzed in our meta-analysis, and most studies were conducted among Asian population. The pooled sensitivity, specificity, and diagnostic odds ratio was 0.620 (95% CI: 0.513-0.716), 0.959 (95% CI: 0.929-0.977), and 38.270 (95% CI: 21.090-69.444), respectively. The AUSROC was 0.91 (95% CI: 0.89-0.94), indicating the high diagnostic performance of ctDNA.
Conclusion : ctDNA is a highly specific and effective biomarker for the detection of EGFR mutation status.
Impact : ctDNA analysis will be a key part of personalized cancer therapy of NSCLC.
Cancer Epidemiology Biomarkers & Prevention , résumé, 2014