Achievable plasma concentrations of gefitinib led to the development of EGFR T790M in vitro, , but EGFR T790M has also been determined in EGFR-mutated cell lines at frequencies of 55% (H1975), 7% (H820), and 2% (the gefitinib-resistant H3255; ref. A single base (c.2369C>T) transition mutation, EGFR T790M, is the most frequent resistance event after first-generation exposure to EGFR TKIs. The T790M mutation in EGFR kinase causes drug resistance by increasing the affinity for ATP Cai-Hong Yun*†, Kristen E. Mengwasser†, Angela V. Toms*†, Michele S. Woo‡, Heidi Greulich‡§, Kwok-Kin Wong‡¶, Matthew Meyerson‡§, and Michael J. Eck*†** Departments of *Biological Chemistry and Molecular Pharmacology and Pathology, Harvard Medical School, 25 Shattuck Street, Boston, Discussion. Almost all patients with EGFR-driven lung cancer who are treated with EGFR tyrosine kinase inhibitors (TKI) develop resistance to treatment. One EGFR mutation, T790M, can be detected rarely as a germline variant where its presence has been associated with familial lung cancer . Nevertheless, several lines of evidence indicate that the T790M mutation confers growth advantage to cancer cells, and it was shown that mice expressing tetracycline-inducible EGFR transgenes harboring the T790M mutation develop lung tumors. 2019 Nov 14;20(22):5701. doi: 10.3390/ijms20225701. Hepatocyte growth factor reduces susceptibility to an irreversible epidermal growth factor receptor inhibitor in EGFR-T790M mutant lung cancer. Epub 2009 Dec 15. Suda K, Mizuuchi H, Maehara Y, Mitsudomi T. Cancer Metastasis Rev. 29 Defined EGFR mutations are detected using DNA isolated from formalin-fixed paraffin-embedded tumor tissue (FFPET) or circulating-free tumor DNA (cfDNA) from plasma derived … Although allosteric EGFR TKIs (e.g., EAI-045) that potentially overcome L858R/T790M/C797S have been identified, there are no effective inhibitors against Del19/T790M… 2010 Jan 1;16(1):174-83. doi: 10.1158/1078-0432.CCR-09-1204. receptor (EGFR) T790M mutation-positive locally advanced or metastatic non-small-cell lung cancer (NSCLC) in adults, only if: • their disease has progressed after first-line treatment with an EGFR tyrosine kinase inhibitor and • the company provides osimertinib according to the commercial arrangement. [5][6], "Treatment approaches for EGFR-inhibitor-resistant patients with non-small-cell lung cancer", "The T790M mutation in EGFR kinase causes drug resistance by increasing the affinity for ATP", "Novel D761Y and common secondary T790M mutations in epidermal growth factor receptor-mutant lung adenocarcinomas with acquired resistance to kinase inhibitors", https://en.wikipedia.org/w/index.php?title=T790M&oldid=994481404, Creative Commons Attribution-ShareAlike License, This page was last edited on 15 December 2020, at 22:58. Cancer. Clinical outcome according to the level of preexisting epidermal growth factor receptor T790M mutation in patients with lung cancer harboring sensitive epidermal growth factor receptor mutations.  |  2015;37:235-241. National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. The T790M-EGFR mutation is a common mutation following resistance to first generation TKIs, with an incidence of about 50-60% 5, 14; subsequent mutations after secondary resistance are varied. The frequency of T790M mutation in EGFR-TKI-naive patients and its dynamic changes during therapy remains unclear [6–8]. Thus, T790M mutation seems to play a double role in the survival of lung cancer cells. The gene view histogram is a graphical view of mutations across EGFR. T790M alleles were then analyzed using ddPCR in 59 plasma samples from 24 NSCLC patients with EGFR mutations, and compared to the T790M status which were determined thorough re-biopsies. Nevertheless, several lines of evidence indicate that the T790M mutation confers growth advantage to cancer cells, and it was shown that mice expressing tetracycline-inducible EGFR transgenes harboring the T790M mutation develop lung tumors. COVID-19 is an emerging, rapidly evolving situation. 6). Rapid detection of the EGFR T790M mutation in non-small cell lung cancer patients as an alternative for EGFR analysis of tissue . 1. Acquired resistance inevitably develops, with the EGFR T790M mutation comprising approximately 55% of the mechanisms of resistance following first- or second-generation EGFR-TKI therapy (e.g. However, a secondary EGFR T790M mutation leads to the clinically acquired resistance to the first‐ and second‐generation EGFR‐TKIs drugs. Whether T790M mutation is acquired or is selected from a preexisting clone has been a matter of …  |  This section shows a general overview of the selected mutation. ... EGFR AA mutation. EGFR T790M is present in 0.53% of AACR GENIE cases, with lung adenocarcinoma, non-small cell lung carcinoma, unknown, squamous cell lung carcinoma, and conventional glioblastoma multiforme having the greatest prevalence . The EGFR T790M mutation is rarely detected during the initial tumor characterization and will, most often, become detectable over the course of treatment with TKI. Rather than directly blocking inhibitor binding to the active site, T790M increases the affinity for ATP so that the inhibitors are outcompeted; covalent inhibitors such as neratinib 6-8 The T790M mutation in EGFR exon 20 is a recurrent mechanism of resistance to first-line EGFR-TKIs, detectable in nearly 50% of tissue specimens at progression [3–5]. Current data suggests that patients with metastatic NSCLC and the T790M mutation may benefit from T790M-targeted therapy (eg, osimertinib) T790M : EGFR-targeted tyrosine kinase inhibitors (eg, gefitinib and erlotinib) have been approved by the FDA for use in treating patients with non-small cell lung cancer (NSCLC) who previously failed to respond to traditional chemotherapy. Studies have found that as many as 2 out of 3 cases (66%) of progression with first-line EGFR TKIs may be related to the EGFR T790M mutation. Clipboard, Search History, and several other advanced features are temporarily unavailable. Mahalapbutr P, Wonganan P, Chavasiri W, Rungrotmongkol T. Cancers (Basel). Several second-generation EGFR-TKIs are currently being developed to overcome the acquired resistance caused by the T790M mutation. 2012 Dec;31(3-4):807-14. doi: 10.1007/s10555-012-9391-7. The T790M mutation is present in about half of the lung cancer patients with acquired resistance, and reported to act by increasing the affinity of the receptor to adenosine triphosphate, relative to its affinity to TKIs. Compared with control vector-transduced cells, the ectopic expression of the T790M mutant markedly altered the sensitivity to afatinib ( Fig. Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) are the currently recommended treatment for advanced EGFR mutation-positive non-small cell lung cancer (NSCLC). EGFR T790M resistance mutation in non small-cell lung carcinoma. A secondary point mutation that substitutes methionine for threonine at amino acid position 790 (T790M) is a molecular mechanism that produces a drug-resistant variant of the targeted kinase.  |  Int J Mol Sci. Families harboring germline EGFR T790M mutations are currently under investigation at our center as part of an ongoing multicenter clinical trial (NCT01754025; ref. The T790M mutation Most patients who receive first/second-generation EGFR TKIs as 1L treatment progress after 9–14 months. The tyrosine kinase inhibitors (TKI) against epidermal growth factor receptor (EGFR) are widely used in patients with non-small cell lung cancer (NSCLC). ... Human Mutation. Commercial arrangement. However, the efficacy and safety of osimertinib for patients with poor PS is unknown. Contact Market.AccessUK@astrazeneca.com for … MET (met proto-oncogene) amplification or activation of IGF1R are reported as alternative mechanisms for acquired resistance to EGFR-TKIs. [3][4], In November 2015, the US FDA granted accelerated approval to osimertinib (Tagrisso) for the treatment of patients with metastatic epidermal growth factor receptor (EGFR) T790M mutation-positive non-small cell lung cancer (NSCLC), as detected by an FDA-approved test, which progressed on or after EGFR TKI therapy. T790M, also known as Thr790Met, is a gatekeeper mutation of the epidermal growth factor receptor (EGFR). Epub 2020 Jun 2. 2019 Mar 28;11(4):437. doi: 10.3390/cancers11040437. In all, 43.7% (47/108) had acquired T790M mutation by ddPCR. Yamada T, Matsumoto K, Wang W, Li Q, Nishioka Y, Sekido Y, Sone S, Yano S. Clin Cancer Res. Plasma circulating tumor DNA (ctDNA) is an ideal approach to detecting the epidermal growth factor receptor (EGFR) T790M mutation, which is a major mechanism of resistance to first-generation EGFR-tyrosine kinase inhibitor (TKI) therapy.The present study aimed to explore the association of ctDNA-identified T790M mutation with disease failure sites and clinical prognosis in … Osimertinib is the only EGFR-tyrosine kinase inhibitor (TKI) capable of overcoming EGFR-T790M–mutated NSCLC, but osimertinib-resistant EGFR triple mutations (Del19/T790M/C797S or L858R/T790M/C797S) have been reported. Characterization and printability of Sodium alginate -Gelatin hydrogel for bioprinting NSCLC co-culture. The cobas ® EGFR Mutation Test v2 is a real-time PCR test for the qualitative detection of defined mutations of the epidermal growth factor receptor (EGFR) gene in non-small cell lung cancer (NSCLC) patients. A pan-cancer assessment of alterations of the kinase domain of ULK1, an upstream regulator of autophagy. Lee Y, Lee GK, Lee YS, Zhang W, Hwang JA, Nam BH, Kim SH, Kim JH, Yun T, Han JY, Kim HT, Lee JS. Calibasi-Kocal G, Amirfallah A, Sever T, Umit Unal O, Gurel D, Oztop I, Ellidokuz H, Basbinar Y. Biomed Rep. 2020 Aug;13(2):2. doi: 10.3892/br.2020.1308. NLM Please enable it to take advantage of the complete set of features! Thus, T790M mutation seems to play a double role in the survival of lung cancer cells. Suda K, Mizuuchi H, Murakami I, Uramoto H, Tanaka F, Sato K, Takemoto T, Iwasaki T, Sekido Y, Yatabe Y, Mitsudomi T. Lung Cancer. 2D ). 2015 Apr 15;444:81-5. doi: 10.1016/j.cca.2015.01.039. These agents include osimertinib, rociletinib, … A single base (c.2369C>T) transition mutation, EGFR T790M, is the most frequent resistance event after first-generation exposure to EGFR TKIs. Threonine is a small polar amino acid; methionine is a larger nonpolar amino acid. NIH Butoxy Mansonone G Inhibits STAT3 and Akt Signaling Pathways in Non-Small Cell Lung Cancers: Combined Experimental and Theoretical Investigations. [2], Over 50% of acquired resistance to EGFR tyrosine kinase inhibitors (TKI) is caused by a mutation in the ATP binding pocket of the EGFR kinase domain involving substitution of a small polar threonine residue with a large nonpolar methionine residue, T790M. Conclusion. Dynamics of T790M and other EGFR mutations using plasma is beneficial in monitoring clinical response and evaluating development of TKI resistance. 2014 Aug;85(2):147-51. doi: 10.1016/j.lungcan.2014.05.018. There is a patient access scheme for osimertinib. These mutations are displayed at the amino acid level across the full length of the gene by default. 6 In up to 60% of these patients, the acquired resistance is driven by a T790M mutation. The mutation substitutes a threonine (T) with a methionine (M) at position 790 of exon 20,[1] affecting the ATP binding pocket of the EGFR kinase domain. In 75 patient plasma samples, comparing ddPCR with ARMS, the rates of T790M mutation were 46.7% (35/75) and 25.3% (19/75) by ddPCR and ARMS, respectively. Clarification of the pathways leading to acquired resistance is essential to maximize the efficacy of EGFR-TKI therapy for patients with lung cancer. 10 This case documents a rare mutation pattern where the main driver gene reverted to the original 19Del-EGFR mutation after developing resistance against third generation TKI. Current Approaches in NSCLC Targeting K-RAS and EGFR. It describes the source of the mutation i.e gene name/sample name/tissue name with unique ID, and also shows the mutation syntax at the amino acid and nucleotide sequence level. Third-generation EGFR TKIs against the T790M mutation have been in active clinical development. The assessment of the optimal assay method revealed that the assay using the short amplicon can efficiently detect more fragmented-DNA. The mutation substitutes a threonine (T) with a methionine (M) at position 790 of exon 20, affecting the ATP binding pocket of the EGFR kinase domain. Epub 2014 Apr 15. 2014 Jul 15;120(14):2090-8. doi: 10.1002/cncr.28711. And 16 patients obtained tissue re-biopsy, using ARMS assay for detecting EGFR T790M mutation. Epidermal growth factor receptor (EGFR) is a transmembrane protein that is activated by binding of its specific ligands, including epidermal growth factor and transforming growth factor α (TGFα) ErbB2 has no known direct activating ligand, and may be in an activated state constitutively or become active upon heterodimerization with other family members such as EGFR. Whether T790M mutation is acquired or is selected from a preexisting clone has been a matter of significant debate. Acquired resistance mechanisms to tyrosine kinase inhibitors in lung cancer with activating epidermal growth factor receptor mutation--diversity, ductility, and destiny. Get the latest public health information from CDC: https://www.coronavirus.gov, Get the latest research information from NIH: https://www.nih.gov/coronavirus, Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. USA.gov. Evidence-based recommendations on osimertinib (Tagrisso) for treating epidermal growth factor receptor (EGFR) T790M mutation-positive locally advanced or metastatic non-small-cell lung cancer (NSCLC) in adults.. Is this guidance up to date? This site needs JavaScript to work properly. To test the effect of T790M mutation on the sensitivity of afatinib, a retroviral mutant EGFR construct containing T790M compound mutation was transduced into PC9 cells. Mondal A, Gebeyehu A, Miranda M, Bahadur D, Patel N, Ramakrishnan S, Rishi AK, Singh M. Sci Rep. 2019 Dec 27;9(1):19914. doi: 10.1038/s41598-019-55034-9. When tumours develop EGFR T790M mutations, it causes the targeted therapy a patient is taking stop working, and the disease starts to progress again. A763_V765dup, p.A763_V765dup, Ala763_Val765dup, A763-V765 duplication in EGFR Exon 20 Effect of EGFR T790M mutation. Nevertheless, several lines of evidence indicate that the T790M mutation confers growth advantage to cancer cells, and it was shown that mice expressing tetracycline-inducible EGFR transgenes harboring the T790M mutation develop lung tumors. Thus, T790M mutation seems to play a double role in the survival of lung cancer cells. EGFR mutations by cobas central test: T790M: 405 (99)d d In the AURA extension trial, 3 patients who did not have an EGFR T790M mutation detected (negative) and 1 patient who was not centrally tested entered the study; these were consequently considered important protocol deviations. p.T790M (Substitution - … Introduction. Threonine is a small polar amino acid; methionine is a larger nonpolar amino acid. Rather than directly blocking inhibitor binding to the active site, T790M increases the affinity for ATP so that the inhibitors are outcompeted; covalent inhibitors such as neratinib can overcome this resistance. NCI CPTC Antibody Characterization Program. HHS T790M, also known as Thr790Met, is a gatekeeper mutation of the epidermal growth factor receptor (EGFR). Even though lung cancer patients harboring a mutation in the epidermal growth factor receptor (EGFR) gene exhibit an initial dramatic response to EGFR tyrosine kinase inhibitors (EGFR-TKIs), acquired resistance is almost inevitable after a progression-free period of approximately 10 months. Epub 2015 Feb 7. According to the researchers, those patients who lots the T790M mutation were more likely to show EGFR-independent pathways as a secondary resistance mechanism. Osimertinib is a third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) that is effective against EGFR T790M mutation-positive non–small-cell lung cancer (NSCLC) in patients who have good performance status (PS). Restrict the view to a region of the gene by dragging across the histogram to highlight the region of interest, or by using the sliders in the filters panel to the left. Since circulating tumor DNA (ctDNA) is present in very low amounts in plasma, high sensitive and … progression-free survival (PFS) and proportion of acquisition of T790M mutation of the epidermal growth receptor gene (EGFR) after first-line treatment with epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) in patient groups with and without tumor expression of … Thus, early detection of the appearance of this mutation is of clinical importance in directing the patient to a more effective treatment. Evaluates peripheral blood for the presence of the T790M mutation in the EGFR gene in cell-free DNA. Sci Rep. 2020 Sep 10;10(1):14874. doi: 10.1038/s41598-020-71527-4. 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