Circulating Free Dna (Cfdna) For Personalized Treatment Of Lung Cancer Patients Without Cytopathologic Diagnosis.

e21143Background: NGS- and PCR- based platforms can detect EGFR mutations in plasma cfDNA with high accuracy. Although tissue biopsy remains the gold standard for initial diagnosis, many pts with suspected advanced NSCLC are unable to undergo biopsy, forgoing potential treatment with highly effective TKIs in pts with sensitizing EGFR mutations. Our study examines the impact of cfDNA to detect EGFR mutations in pts plasma, where tissue biopsy is not feasible. Methods: This is a prospective study of 30 Chinese pts from 09/2016 – 09/2017 with suspected advanced lung cancer (by symptoms and imaging) who were unable to have a biopsy for initial diagnosis due to comorbidities or poor performance status (PS). NGS- or PCR-based (ARMS) sequencing was used to detect EGFR mutations in pts plasma. Pts with sensitizing mutations were treated with 1st generation EGFR TKIs and followed with serial imaging. Primary endpoint was progression-free survival (PFS) and secondary end points were objective response rates (ORR) a...