Detection of the EGFR-T790M mutation in Exhaled Breath Condensate

Lung biopsies are usually small and have limited amounts of tumour tissue. They are often difficult to obtain as they can cause injury to the patient. Detecting genetic changes in tumours (?mutations?) requires that biopsies have enough tumour tissue for analysis. A significant proportion of patients will not have their tumours sufficiently analysed, as they are unable to have a biopsy done, or if they do have a biopsy done the samples are too small to analyse. EGFR family mutations are tumour mutations that cause patients to respond better to treatment with drugs called tyrosine kinase inhibitors (TKIs), which have less side effects than conventional chemotherapy. Lung cancer patients with EGFR-mutated lung cancers who receive TKIs all eventually become resistant to these drugs. In just over half of patients, one of the EGFR family mutations called ?T790M? is responsible for the development of this resistance. Thankfully, T790M is readily treatable with a newer drug called Osimertinib if the mutation is detected. However, finding the T790M mutation in a patient?s tumour is difficult due to all of the reasons outlined above. We believe that we can find the EGFR-T790M mutations in a non-invasive, novel and safe way. Currently blood samples are being investigated to see if T790M can be detected, but their accuracy is too low to recommend their widespread use, as there are many false negative results. Therefore, combined testing of blood with another source of sample is needed to improve the detection of these mutations. Exhaled breath condensate (EBC) is collected from patients by asking them to breathe into a cooled tube (RTube). In patients with lung cancer, mutations have been detected in EBC. In this study we want to show that combined testing for T790M using both EBC and blood is more effective than using blood alone.

Award Date
07 December 2018
Award Value
€998,318.18
Principal Investigator
Professor Bryan Hennessy
Host Institution
Royal College of Surgeons in Ireland
Scheme
Definitive Interventions and Feasibility Awards