Profil Angka Kejadian Mutasi EXON20 T790M dengan Liquid Biopsy pada Pasien Adenokarsinoma Paru yang Mendapatkan Pengobatan EGFR-TKI di RSUP H. Adam Malik Medan

Abstract

Background: Theoretically, lung cancer patients receiving treatment with EGFRTKI will experience acquired resistance within 7-16 months from the start of treatment, which is indicated by the appearance of exon 20 T790M mutations in the patient. This will result in the EGFR-TKI treatment received so far being ineffective, and cancer cells can develop again. This study aims to determine the demographic profile and clinical profile of the incidence of acquired resistance by using liquid biopsy examination in patients with lung adenocarcinoma who received EGFR TKI therapy. Methods: A descriptive study with a retrospective cohort design was carried out at the Oncology Polyclinic at H Adam Malik Hospital Medan from October 2020 to January 2021. The subjects were all patients with lung cancer of the adenocarcinoma type with histopathological, cytological or both who had received therapy with EGFR TKI for more than 6 months. The method of droplet digital polymerase chain reaction (ddPCR) was performed to detect EGFR exon 20 T790M mutations. Results: A total of 31 patients met the requirements as subjects. It was found that the majority of subjects were female (64.5%), aged 20-69 years (58%) and nonsmokers (67.7%). The most common EGFR mutation was exon 19 deletion (58.1%). Acquired resistance events were found in 10 subjects (32.3%). Patients with acquired resistance were dominated by women (70%), without a history of smoking (80%), with Gefitinib treatment (90%). The average length of time for EGFR-TKI treatment until acquired resistance occurs is 12.6 months. Conclusion: The incidence of acquired resistance was mainly found in women without smoking history after 12.6 months of treatment with EGFR TKI.