ArticleTranslational lung cancer research2026
Clinical implications of plasma EGFR T790M and ctDNA shedding across metastatic sites in plasma- or tissue-confirmed EGFR-mutant non-small cell lung cancer treated with lazertinib: a prospective multicenter cohort study.
Article in Translational lung cancer research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors improve outcomes in EGFR T790M-positive non-small cell lung cancer (NSCLC), but the prognostic value of plasma-detected T790M remains uncertain. We evaluated the clinical significance of baseline plasma T790M in patients treated with lazertinib, accounting for metastatic distribution and coexisting genomic alterations. Methods: In this prospective multicenter cohort, we analyzed 117 patients with EGFR-mutant NSCLC who received lazertinib after T790M confirmation in tissue or plasma. Plasma EGFR mutations were profiled using next-generation sequencing before treatment. Progression-free survival (PFS) and overall survival (OS) were compared by plasma T790M status, metastatic sites, and co-alterations. Results: Of 117 patients, 92 were plasma T790M-positive and 25 were plasma T790M-negative. Plasma T790M positivity was associated with shorter PFS (10.0 Conclusions: Baseline plasma T790M, interpreted alongside metastatic distribution, provided prognostic information in EGFR-mutant NSCLC treated with lazertinib. Liver and adrenal metastases occurred exclusively in plasma T790M-positive patients and were associated with markedly worse outcomes, consistent with a ctDNA-shedding phenotype. Bone metastasis was an adverse prognostic factor independent of plasma T790M, underscoring the combined prognostic impact of molecular and metastatic features.
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