1Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
2Department of Biostatistics, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
3Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
Copyright © 2023 by the Korean Cancer Association
This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Author Contributions
Conceived and designed the analysis: Kim S, Kim SH, Kim MH, Lee MK, Eom JS.
Collected the data: Kim S, Kim SH, Kim MH, Lee MK, Eom JS.
Contributed data or analysis tools: Kim S, Kim SH, Kim MH, Lee MK, Eom JS.
Performed the analysis: Kim J, Eom JS.
Wrote the paper: Kim S, Kim SH, Eom JS.
Conflicts of Interest
Eom JS received speaker fees from Yuhan, Boehringer Ingelheim, Amgen, AstraZeneca, Olympus, and Erbe Corporations as an invited speaker at academic medical meetings. Eom JS reports grants from Boehringer Ingelheim. Kim SH received speaker fees from AstraZeneca. Kim S has no conflict of interest directly relevant to the content of this article.
Study | Year | No. of patients | Age (yr)a) |
EGFR T790M mutation detection rate, n (%) |
|||||
---|---|---|---|---|---|---|---|---|---|
First rebiopsy |
Repeated rebiopsy |
||||||||
Overall | Tissue or cytology | Liquid | Overall | Tissue or cytology | Liquid | ||||
Kuiper et al. [14] | 2014 | 66 | 54 | 34/66 (52) | - | - | 17/27 (63) | - | - |
Ichihara et al. [10] | 2018 | 55 | 66 | 25/55 (45) | - | - | 12/21 (57) | - | - |
Seto et al. [8] | 2018 | 236 | 73 | 49/205 (24) | 22/68 (32) | 27/137 (20) | 12/50 (24)b) | 9/37 (24) | 3/21 (14) |
Lee et al. [15] | 2019 | 338 | 59 | 133/274 (49) | - | - | 16/35 (46) | - | - |
Chiang et al. [16] | 2020 | 240 | 63 | 127/240 (53) | - | - | 14/38 (37) | 10/33 (30) | 4/5 (80) |
Chu et al. [17] | 2020 | 84 | 63 | 33/78 (42) | - | - | 14/25 (56) | - | - |
Ninomaru et al. [11] | 2021 | 50 | 73 | 18/50 (36) | - | - | 22/32 (69) | - | - |
Kudo et al. [12] | 2022 | 63 | 72 | 29/63 (46) | 23/51 (45) | 6/12 (50) | 7/20 (35)b) | 5/23 (22) | 2/4 (50) |
Study |
Risk of bias |
Applicability concerns |
|||||
---|---|---|---|---|---|---|---|
Patient selection | Index test | Reference standard | Flow and time | Patient selection | Index test | Reference standard | |
Kuiper et al. (2014) [14] | Low | Unclear | Unclear | Low | Low | Low | Low |
Ichihara et al. (2018) [10] | Low | Unclear | Unclear | Unclear | Low | Low | Low |
Seto et al. (2018) [8] | Low | Unclear | Unclear | Unclear | Low | Low | Low |
Lee et al. (2019) [15] | Low | Unclear | Unclear | High | Low | Low | Low |
Chiang et al. (2020) [16] | Low | Unclear | Unclear | Unclear | Low | Low | Low |
Chu et al. (2020) [17] | Low | Unclear | Unclear | Unclear | Low | Low | Unclear |
Ninomaru et al. (2021) [11] | Low | Unclear | Unclear | Unclear | Low | Low | Low |
Kudo et al. (2022) [12] | Low | Unclear | Unclear | Unclear | Low | Low | Low |
Study | ORR (%) | DCR (%) | PFS (mo) | |||
---|---|---|---|---|---|---|
First rebiopsy | Repeated rebiopsy | First rebiopsy | Repeated rebiopsy | First rebiopsy | Repeated rebiopsy | |
Ichihara et al. [10] | 56 | 50 | 89 | 70 | N/A | N/A |
Ninomaru et al. [11] | 82 | 77 | 94 | 91 | 23 | 21 |
Kudo et al. [12] | N/A | N/A | N/A | N/A | 12 | 16 |
Chiang et al. [16] | N/A | N/A | N/A | N/A | 15 | 13 |
Search strategy for meta-analysis
Search strategy | Search terms |
---|---|
1 | EGFR and rebiopsy |
2 | EGFR and repeated rebiopsy |
3 | EGFR and multiple rebiopsy |
4 | EGFR and additional rebiopsy |
5 | EGFR and second rebiopsy |
6 | T790M and rebiopsy |
7 | T790M and repeated rebiopsy |
8 | T790M and multiple rebiopsy |
9 | T790M and additional rebiopsy |
10 | T790M and second rebiopsy |
EGFR, epidermal growth factor receptor.
Study characteristics
Study | Year | No. of patients | Age (yr) |
EGFR T790M mutation detection rate, n (%) | |||||
---|---|---|---|---|---|---|---|---|---|
First rebiopsy |
Repeated rebiopsy | ||||||||
Overall | Tissue or cytology | Liquid | Overall | Tissue or cytology | Liquid | ||||
Kuiper et al. [ |
2014 | 66 | 54 | 34/66 (52) | - | - | 17/27 (63) | - | - |
Ichihara et al. [ |
2018 | 55 | 66 | 25/55 (45) | - | - | 12/21 (57) | - | - |
Seto et al. [ |
2018 | 236 | 73 | 49/205 (24) | 22/68 (32) | 27/137 (20) | 12/50 (24) |
9/37 (24) | 3/21 (14) |
Lee et al. [ |
2019 | 338 | 59 | 133/274 (49) | - | - | 16/35 (46) | - | - |
Chiang et al. [ |
2020 | 240 | 63 | 127/240 (53) | - | - | 14/38 (37) | 10/33 (30) | 4/5 (80) |
Chu et al. [ |
2020 | 84 | 63 | 33/78 (42) | - | - | 14/25 (56) | - | - |
Ninomaru et al. [ |
2021 | 50 | 73 | 18/50 (36) | - | - | 22/32 (69) | - | - |
Kudo et al. [ |
2022 | 63 | 72 | 29/63 (46) | 23/51 (45) | 6/12 (50) | 7/20 (35) |
5/23 (22) | 2/4 (50) |
EGFR, epidermal growth factor receptor.
a)Age is presented using the median in all selected studies,
b)Some patients underwent repeated rebiopsy using both tissue and plasma samples.
Quality assessment for the risk of bias of the included studies
Study | Risk of bias |
Applicability concerns | |||||
---|---|---|---|---|---|---|---|
Patient selection | Index test | Reference standard | Flow and time | Patient selection | Index test | Reference standard | |
Kuiper et al. (2014) [ |
Low | Unclear | Unclear | Low | Low | Low | Low |
Ichihara et al. (2018) [ |
Low | Unclear | Unclear | Unclear | Low | Low | Low |
Seto et al. (2018) [ |
Low | Unclear | Unclear | Unclear | Low | Low | Low |
Lee et al. (2019) [ |
Low | Unclear | Unclear | High | Low | Low | Low |
Chiang et al. (2020) [ |
Low | Unclear | Unclear | Unclear | Low | Low | Low |
Chu et al. (2020) [ |
Low | Unclear | Unclear | Unclear | Low | Low | Unclear |
Ninomaru et al. (2021) [ |
Low | Unclear | Unclear | Unclear | Low | Low | Low |
Kudo et al. (2022) [ |
Low | Unclear | Unclear | Unclear | Low | Low | Low |
Comparisons of clinical outcomes after osimertinib treatment between patients with T790M at the first rebiopsy and patients with T790M at the repeated rebiopsy
Study | ORR (%) | DCR (%) | PFS (mo) | |||
---|---|---|---|---|---|---|
First rebiopsy | Repeated rebiopsy | First rebiopsy | Repeated rebiopsy | First rebiopsy | Repeated rebiopsy | |
Ichihara et al. [ |
56 | 50 | 89 | 70 | N/A | N/A |
Ninomaru et al. [ |
82 | 77 | 94 | 91 | 23 | 21 |
Kudo et al. [ |
N/A | N/A | N/A | N/A | 12 | 16 |
Chiang et al. [ |
N/A | N/A | N/A | N/A | 15 | 13 |
DCR, disease control rate; N/A, not available; ORR, objective response rate; PFS, progression-free survival.
EGFR, epidermal growth factor receptor.
Age is presented using the median in all selected studies, Some patients underwent repeated rebiopsy using both tissue and plasma samples.
DCR, disease control rate; N/A, not available; ORR, objective response rate; PFS, progression-free survival.