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The utilization of next-generation sequencing to detect somatic mutations and predict clinical prognosis of Chinese non-small cell lung cancer patients

Authors Cao L, Long L, Li M, Yang H, Deng P, Mao X, Xiang J, Li B, Zhang T, Hu C

Received 3 November 2017

Accepted for publication 10 January 2018

Published 8 May 2018 Volume 2018:11 Pages 2637—2646


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 4

Editor who approved publication: Dr Cho

Liming Cao,1 Long Long,2 Min Li,1 Huaping Yang,1 Pengbo Deng,1 Xinru Mao,3 Jianxing Xiang,3 Bing Li,3 Tengfei Zhang,3 Chengping Hu1

1Department of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China; 2Department of Cardiothoracic Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, China; 3Burning Rock Biotech, Guangzhou, China

Purpose: The development of next-generation sequencing (NGS) has revolutionized the understanding of oncogenesis of multiple types of cancer, including non-small cell lung cancer (NSCLC). However, there has been some debate over the utility of NGS for predicting patient prognosis and determining molecular targeted therapy. Therefore, we sought to demonstrate the numerous applications of NGS in the prognostic predictions and treatment of NSCLC patients.
Materials and methods: We performed NGS on either liquid or tissue tumor biopsies obtained from 53 NSCLC patients. The sequences were analyzed for oncogenic mutations, which were then correlated to clinical prognosis and smoking history.
Results: NGS of tumor biopsies detected both well-known driver mutations as well as rare or novel mutations. EGFR was the most frequently mutated gene, accounting for 32.4% (33/102) of the somatic mutations in this study. The EGFR mutations detected included rare variants such as EGFR exon 19 insertion (K745_E746insIPVAIK) and in cis H835L+L833V. Additionally, novel RET fusion mutations PCM1–RET and ADD3-RET were detected in two adenocarcinoma patients. To demonstrate the functional applications of NGS, we correlated mutations with patient characteristics, outcomes of matched targeted therapy, and outcomes based on allelic frequency of the EGFR-T790M mutation. Finally, we demonstrated that circulating tumor DNA can be used both to measure response to targeted therapy and as a predictor of clinical outcome, by presenting a case study of a single patient.
Conclusion: We demonstrated that NGS can be used in multiple applications to effectively identify potential oncogenic driver mutations, guide mutation-targeted therapy decisions, and predict clinical outcomes in Chinese NSCLC patients.

Keywords: next-generation sequencing, non-small cell lung cancer, prognosis

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