Evidence map›Paper›PMID 41468685›Full record

ArticleESMO open2026

Clinical utility of pleural effusion supernatant cell-free DNA genotyping in previously treated patients with advanced non-small-cell lung cancer and disease progression: a multicenter retrospective study.

S-C Chang, C-Y Huang, Y-C Lai, M-S Hsieh, C-C Ho, C-Y Yang, J-Y Shih, S-G Wu, P-W Hu, C-L Hsu and 2 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in ESMO open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

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5 · Who and what money

Authors and funding

12 authors.

S-C ChangDivision of Chest Medicine, Department of Internal Medicine, National Yang Ming Chiao Tung University Hospital, Yi-Lan, Taiwan; Department of Critical Care Medicine, National Yang Ming Chiao Tung University Hospital, Yi-Lan, Taiwan; School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
C-Y HuangDivision of Chest Medicine, Department of Internal Medicine, Taipei Tzu Chi Hospital, Taipei, Taiwan.
Y-C LaiDivision of Chest Medicine, Department of Internal Medicine, National Yang Ming Chiao Tung University Hospital, Yi-Lan, Taiwan; School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
M-S HsiehDepartment of Pathology, National Taiwan University Hospital, Taipei, Taiwan; College of Medicine, National Taiwan University, Taipei, Taiwan.
C-C HoCollege of Medicine, National Taiwan University, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
C-Y YangCollege of Medicine, National Taiwan University, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
J-Y ShihCollege of Medicine, National Taiwan University, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
S-G WuCollege of Medicine, National Taiwan University, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Cancer Center, Taipei, Taiwan.
P-W HuDivision of Chest Medicine, Department of Internal Medicine, National Yang Ming Chiao Tung University Hospital, Yi-Lan, Taiwan; School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
C-L HsuCollege of Medicine, National Taiwan University, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
C-Y ChenCollege of Medicine, National Taiwan University, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan.
W-Y LiaoCollege of Medicine, National Taiwan University, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: wyliao33@ntu.edu.tw.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPatients with lung cancer frequently develop pleural effusion as the disease progresses. This study evaluated the utility of cell-free DNA (cfDNA) from pleural effusion supernatant in identifying targetable mutations in non-small-cell lung cancer (NSCLC) patients who developed resistance to prior therapies.

methodsWe conducted a multicenter retrospective study involving 95 patients who experienced disease progression after at least one line of treatment and underwent pleural effusion cfDNA next-generation sequencing testing.

resultsInitial routine molecular testing detected various driver mutations in 70 (73.7%) patients, while 26.3% had no detectable driver mutations. Subsequent cfDNA next-generation sequencing identified additional genomic alterations during disease progression, increasing the detection rate for driver mutations from 73.7% to 85.3%. For patients whose disease progressed after treatment with first- or second-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors, 40.7% developed an acquired EGFR T790M mutation, and showed clinical benefit with subsequent administration of osimertinib. Of the 29 patients who progressed following osimertinib treatment, 14 received osimertinib as a first-line therapy, and 15 received osimertinib as a second-line therapy. MET copy number gain (CNG) was identified in 28.6% of patients receiving first-line osimertinib and was associated with a significantly shorter progression-free survival (PFS) of 12.0 months versus 23.0 months for those without MET CNG [hazard ratio (HR) = 18.68, P = 0.00088]. CNG in MET and KRAS was linked to poorer overall survival. Among the patients for whom second-line osimertinib failed, five acquired the EGFR C797S mutation, and four exhibited MYC CNG. MYC CNG was associated with a median PFS of 8.5 months versus 25.0 months for those without MYC CNG (HR 8.4, P = 0.0046).

conclusionCfDNA sampling from pleural effusion is a less invasive and more effective method for genomic profiling in NSCLC with disease progression, offering valuable insights to guide personalized treatment strategies.

Indexed as

Carcinoma, Non-Small-Cell LungCell-Free Nucleic AcidsLung NeoplasmsPleural EffusionAdultAgedAged, 80 and overDisease ProgressionFemaleHigh-Throughput Nucleotide SequencingHumansMaleMiddle AgedMutationRetrospective StudiesCell-Free Nucleic AcidscfDNAdisease progressionnon-small-cell lung cancerpleural effusion

Identifiers

PMID41468685
PMCPMC12804021

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.