Noninvasive saliva-based EGFR gene mutation detection in patients with lung cancer

Fang Wei, Chien Chung Lin, Aron Joon, Ziding Feng, Gabriel Troche, Maruja E. Lira, David Chia, Mao Mao, Chung Liang Ho, Wu Chou Su, David T.W. Wong

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81 Citations (Scopus)

Abstract

Rationale: Constitutive activation of the epidermal growth factor receptor (EGFR) is prevalent in epithelial cancers, particularly in non-small cell lung carcinoma (NSCLC). Mutations identified in EGFR predict the sensitivity to EGFR-targeted therapy. Detection of these mutations is mainly based on tissue biopsy, which is invasive, expensive, and time consuming. Objectives: Noninvasive, real-time, inexpensive detection and monitoring of EGFR mutations in patients with NSCLC is highly desirable. Methods: We developed a novel core technology, electric field-induced release and measurement (EFIRM), which relies on a multiplexible electrochemical sensor that can detect EGFR mutations directly in bodily fluids. Measurements and Main Results: We established EFIRM for the detection of the EGFR mutations in vitro and correlated the results with tumor size from xenografted mice. In clinical application, we demonstrated that EFIRM could detect EGFR mutations in the saliva and plasma of 22 patients with NSCLC. Finally, a blinded test was performed on saliva samples from 40 patients with NSCLC. The receiver operating characteristic analysis indicated that EFIRM detected the exon 19 deletion with an area under the curve of 0.94 and the L858R mutation with an area under the curve of 0.96. Conclusions: Our data indicate that EFIRM is effective, accurate, rapid, user-friendly, and cost effective for the detection of EGFR mutations in the saliva of patients with NSCLC. We termed this saliva-based EGFR mutation detection (SABER).

Original languageEnglish
Pages (from-to)1117-1126
Number of pages10
JournalAmerican Journal of Respiratory and Critical Care Medicine
Volume190
Issue number10
DOIs
Publication statusPublished - 2014 Nov 15

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All Science Journal Classification (ASJC) codes

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine

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