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Resistance mutations often exist in a tiny fraction of cells before treatment starts. Error-corrected sequencing that detects variants below 0.01 percent allele fraction could find them at diagnosis and prompt a mechanism-matched combination from day one.
Duplex or error-corrected sequencing detects variants below 0.01 percent allele fraction. Pre-existing resistance clones (EGFR T790M before first-generation TKIs, KRAS in colorectal cancer before anti-EGFR, ESR1 in breast cancer) predict early failure. The proposal is a baseline ultra-deep panel of known resistance alleles for every patient starting a targeted drug, with a pre-specified rule to add the mechanism-matched second agent if a clone is found.
Anyone diagnosed with advanced lung cancer should have EGFR testing before treatment, because osimertinib as the first drug gives the longest disease control, protects the brain, and is well tolerated. Chemotherapy is not the first step for these patients. The remaining questions are whether to intensify upfront (adding chemotherapy or amivantamab) and how to treat resistance when it develops.
One of the most cited trial reports Europe PMC returns for EGFR in Non-small-cell lung cancer, so it is a natural first reading for anyone weighing the idea it is linked from. The record was linked automatically by title and abstract; read the abstract above and the paper itself before relying on any figure.
One of the most cited trial reports Europe PMC returns for EGFR in Non-small-cell lung cancer, so it is a natural first reading for anyone weighing the idea it is linked from. The record was linked automatically by title and abstract; read the abstract above and the paper itself before relying on any figure.
Shares Erlotinib versus standard chemotherapy as first-line treatment for European patients with advanced EGFR mutation-positive non-small-cell lung cancer (EURTAC): a multicentre, open-label, randomised phase 3 trial, Gefitinib or chemotherapy for non-small-cell lung cancer with mutated EGFR, FLAURA: osimertinib as first treatment for EGFR-mutated lung cancer, Tumour heterogeneity and clonal evolution.
Shares Erlotinib versus standard chemotherapy as first-line treatment for European patients with advanced EGFR mutation-positive non-small-cell lung cancer (EURTAC): a multicentre, open-label, randomised phase 3 trial, Gefitinib or chemotherapy for non-small-cell lung cancer with mutated EGFR, FLAURA: osimertinib as first treatment for EGFR-mutated lung cancer, Acquired resistance to every therapy.
Shares Tumour heterogeneity and clonal evolution, Acquired resistance to every therapy, Comprehensive genomic profiling, Liquid biopsy (ctDNA).
Shares Erlotinib versus standard chemotherapy as first-line treatment for European patients with advanced EGFR mutation-positive non-small-cell lung cancer (EURTAC): a multicentre, open-label, randomised phase 3 trial, Gefitinib or chemotherapy for non-small-cell lung cancer with mutated EGFR, FLAURA: osimertinib as first treatment for EGFR-mutated lung cancer, EGFR.
Shares Variant allele frequency (VAF), Tumour heterogeneity and clonal evolution, Acquired resistance to every therapy, Liquid biopsy (ctDNA).
Shares Erlotinib versus standard chemotherapy as first-line treatment for European patients with advanced EGFR mutation-positive non-small-cell lung cancer (EURTAC): a multicentre, open-label, randomised phase 3 trial, Gefitinib or chemotherapy for non-small-cell lung cancer with mutated EGFR, FLAURA: osimertinib as first treatment for EGFR-mutated lung cancer, EGFR.
Shares Tumour heterogeneity and clonal evolution, Acquired resistance to every therapy, Liquid biopsy (ctDNA), Non-small-cell lung cancer.
Shares FLAURA: osimertinib as first treatment for EGFR-mutated lung cancer, Acquired resistance to every therapy, EGFR, Liquid biopsy (ctDNA).