{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T21:39:24Z","timestamp":1789767564305,"version":"4.0.1"},"reference-count":29,"publisher":"Walter de Gruyter GmbH","issue":"7","license":[{"start":{"date-parts":[[2021,3,11]],"date-time":"2021-03-11T00:00:00Z","timestamp":1615420800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Consejer\u00eda de Ciencia, Universidades e Innovaci\u00f3n de la Comunidad de Madrid","award":["IND2019\/BMD-17258"],"award-info":[{"award-number":["IND2019\/BMD-17258"]}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["IFI18\/00051"],"award-info":[{"award-number":["IFI18\/00051"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,6,25]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec id=\"j_cclm-2020-1465_abs_001_w2aab3b7c19b1b6b1aab1c17b1Aa\">\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Epidermal growth factor receptor (<jats:italic>EGFR<\/jats:italic>) biomarker testing using blood-based liquid biopsies remains challenging due to the low concentration of circulating tumor DNA (ctDNA) in certain plasma samples. The aim of this study is to evaluate the usefulness for <jats:italic>EGFR<\/jats:italic> biomarker testing of ctDNA from pleural effusions, cerebrospinal fluids, ascites and pericardial effusions obtained during the clinical management of lung adenocarcinoma patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_cclm-2020-1465_abs_002_w2aab3b7c19b1b6b1aab1c17b2Aa\">\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>For comparison purposes, 23 paired plasma and body fluid samples were collected from 17 patients with <jats:italic>EGFR<\/jats:italic>-positive lung adenocarcinoma. After circulating free DNA (cfDNA) isolation, samples were evaluated for the initial <jats:italic>EGFR<\/jats:italic>-sensitizing mutation and the p.T790M resistance mutation by array-based digital PCR (dPCR).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_cclm-2020-1465_abs_003_w2aab3b7c19b1b6b1aab1c17b3Aa\">\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Body fluids had more cfDNA than plasma samples (1.90 vs. 0.36\u00a0ng\/\u00b5L; p=0.0130), and more samples tested positive for <jats:italic>EGFR<\/jats:italic> mutations (21 vs. 16 samples), with a total of 28 vs. 22 variants detected. Furthermore, mutant allele frequencies (MAFs) observed in body fluids were significantly higher than those assessed in the paired plasma samples for <jats:italic>EGFR<\/jats:italic>-sensitizing mutations (median MAFs\u00a0=\u00a015.8 vs. 0.8%; p=0.0004) as well as for the p.T790M resistance mutation (median MAFs\u00a0=\u00a08.69 vs. 0.16%; p=0.0390). Importantly, two patients who had progressed on first-generation <jats:italic>EGFR<\/jats:italic>-tyrosine kinase inhibitors with a dubious result for p.T790M plasma (MAFs\u00a0=\u00a00.11%) had an indisputably positive result in their respective body fluid samples (MAFs\u00a0=\u00a010.25 and 9.66%).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_cclm-2020-1465_abs_004_w2aab3b7c19b1b6b1aab1c17b4Aa\">\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>ctDNA derived from body fluids is an informative source for <jats:italic>EGFR<\/jats:italic> biomarker testing, with greater sensitivity than plasma samples.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1515\/cclm-2020-1465","type":"journal-article","created":{"date-parts":[[2021,3,11]],"date-time":"2021-03-11T00:49:41Z","timestamp":1615423781000},"page":"1221-1229","source":"Crossref","is-referenced-by-count":16,"title":["ctDNA from body fluids is an adequate source for <i>EGFR<\/i> biomarker testing in advanced lung adenocarcinoma"],"prefix":"10.1515","volume":"59","author":[{"given":"Clara","family":"P\u00e9rez-Barrios","sequence":"first","affiliation":[{"name":"Laboratory Medicine Department , Hospital Universitario Puerta de Hierro-Majadahonda , Madrid , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2805-0312","authenticated-orcid":false,"given":"Estela","family":"S\u00e1nchez-Herrero","sequence":"additional","affiliation":[{"name":"Molecular Oncology Laboratory , Biomedical Sciences Research Institute, Hospital Universitario Puerta de Hierro-Majadahonda , Madrid , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia","family":"Garcia-Sim\u00f3n","sequence":"additional","affiliation":[{"name":"Laboratory Medicine Department , Hospital Universitario Puerta de Hierro-Majadahonda , Madrid , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel","family":"Barqu\u00edn","sequence":"additional","affiliation":[{"name":"Molecular Oncology Laboratory , Biomedical Sciences Research Institute, Hospital Universitario Puerta de Hierro-Majadahonda , Madrid , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariola Blanco","family":"Clemente","sequence":"additional","affiliation":[{"name":"Medical Oncology Department , Hospital Universitario Puerta de Hierro-Majadahonda , Madrid , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariano","family":"Provencio","sequence":"additional","affiliation":[{"name":"Medical Oncology Department , Hospital Universitario Puerta de Hierro-Majadahonda , Madrid , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1634-7397","authenticated-orcid":false,"given":"Atocha","family":"Romero","sequence":"additional","affiliation":[{"name":"Molecular Oncology Laboratory , Biomedical Sciences Research Institute, Hospital Universitario Puerta de Hierro-Majadahonda , Madrid , Spain"},{"name":"Medical Oncology Department , Hospital Universitario Puerta de Hierro-Majadahonda , Madrid , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2021,3,11]]},"reference":[{"key":"2023033110501840802_j_cclm-2020-1465_ref_001_w2aab3b7c19b1b6b1ab2b2b1Aa","unstructured":"Lung cancer metastatic. 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