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Egfr ppt.pptx

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Sangeeta Khyalia

This study aims to assess the prevalence of EGFR mutations in patients with advanced non-small cell lung carcinoma (NSCLC) at a tertiary care center in Rajasthan, India. The study will collect tissue samples from 90 NSCLC patients and test for EGFR mutations using real-time PCR. Previous studies have found EGFR mutation rates ranging from 20-37.9% in Indian NSCLC patients. Detecting EGFR mutations could help predict response to EGFR tyrosine kinase inhibitors and improve patient outcomes. This would be the first study to report the prevalence of EGFR mutations in lung cancer patients in Rajasthan.

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EGFR mutation testing in patients with Advanced NSCLC at Tertiary care center of Rajasthan SMS MEDICAL COLLEGE,JAIPUR Presented By: Dr Ranjana Solanki Professor, Dept of Pathology, Nodal Officer, MDRU Lab,
Introduction
In India, lung cancer is the second most common cancer in men and the fourth most common cancer in the overall population (Globocon 2018). EGFR is a tyrosine kinase receptor belonging to the ErbB family; it is widely expressed in NSCLC (40-80% of NSCLC) and plays a significant role in carcinogenesis. Several investigators worldwide have identified activating somatic mutations in the kinase domain of EGFR in NSCLC patients ranging from 10% in United States to 30% to 50 % in Asian population. There have been several studies conducted from different parts of our country regarding the prevalence of EGFR mutations in patients of NSCLC which range from 20% to 37.9%. Usefulness of EGFR mutation testing in all NSCLC patients at SMS Medical College would help in identification of a subset of patients who could benefit from EGFR TKI therapy at the time of initial presentation of the disease, thereby controlling the progression and providing survival benefits.
Aims & Objectives of the study Aim: To assess the prevalence of specific EGFR mutations in patients with advanced non-small cell lung carcinoma. Objectives: 1) To detect the EGFR mutation in patients with advanced non-small cell lung carcinoma by Real Time PCR. 2) To establish clinical association in patients with EGFR mutations. 3) To assess the treatment response, time to progression and overall survival, in patients with and without EGFR mutations.
Sample Size Sample size is calculated at 95% confidence level assuming 30% prevalence of EGFR mutations in non-small cell lung cancer patients as found in seed article Bharadwaj R et al. 2016). At the absolute allowable error of 10%, 84 cases of non-small cell lung cancer are required for sample size which is further enhanced and rounded off to 90 cases as final sample size, expecting 10% attrition or loss to follow up.
Methodology A total of 90 tissue sample of NSCLC patients will be collected attending OPD & IPD at SMS Medical College & attached Hospital, Jaipur. Clinical data in the form of age, gender, smoking status, occupation, local residence, family history of cancer will be obtained from clinical records Radiological details particularly CT chest findings at presentation will be noted and images archived in a database Lung Biopsy with histopathological examination and IHC study.. DNA extraction from tissue samples by using FFPE kit as per manufactures instructions. DNA quality check by using a Nanodrop . Real Time PCR for clinically relevant EGFR mutations by using Qiagen thera screen EGFR RGQ PCR Kit .EGFR Mutation assay will be done along with the positive control and no template control (NTC). The analysis will be performed according to the manufacturers instructions and data will be analyzed by looking at CT (Cycle of the threshold) values.
Flow chart Sample collection 90 cases of NSCLC patients Lung Biopsy (Histomorphology and IHC ) DNA Extraction from FFPE EGFR Mutation by using Real Time PCR Data Analysis Inclusion criteria Exclusion criteria Non Small cell Lung Cancer Inference
Expected outcomes We expect to understand the prevalence of EGFR mutations and its contribution to lung cancer. Detection of these mutations would help in the effective prediction of response to EGFR-TKIs and also would help to detect the presence of secondary mutations that could alter the response of the patients to drugs. Novelty of the study: Our study will highlight the prevalence of EGFR mutations in Lung cancer in Rajasthan for the first time. This will help in outlining a systematic treatment protocol for such patients.
Budget for the study S.No. Items Quantity Approx. Price 1 FFPE Tissue extraction kit 2 kits (50test each) Rs.1,00,000 2 RGQ Real Time PCR kit 3 kits (24rxns each) Rs 3,00,000 3 Misllaneous Items Rs 50,000 Total Rs 4,50,000/-
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Egfr ppt.pptx

  • 1. EGFR mutation testing in patients with Advanced NSCLC at Tertiary care center of Rajasthan SMS MEDICAL COLLEGE,JAIPUR Presented By: Dr Ranjana Solanki Professor, Dept of Pathology, Nodal Officer, MDRU Lab,
  • 3. In India, lung cancer is the second most common cancer in men and the fourth most common cancer in the overall population (Globocon 2018). EGFR is a tyrosine kinase receptor belonging to the ErbB family; it is widely expressed in NSCLC (40-80% of NSCLC) and plays a significant role in carcinogenesis. Several investigators worldwide have identified activating somatic mutations in the kinase domain of EGFR in NSCLC patients ranging from 10% in United States to 30% to 50 % in Asian population. There have been several studies conducted from different parts of our country regarding the prevalence of EGFR mutations in patients of NSCLC which range from 20% to 37.9%. Usefulness of EGFR mutation testing in all NSCLC patients at SMS Medical College would help in identification of a subset of patients who could benefit from EGFR TKI therapy at the time of initial presentation of the disease, thereby controlling the progression and providing survival benefits.
  • 4. Aims & Objectives of the study Aim: To assess the prevalence of specific EGFR mutations in patients with advanced non-small cell lung carcinoma. Objectives: 1) To detect the EGFR mutation in patients with advanced non-small cell lung carcinoma by Real Time PCR. 2) To establish clinical association in patients with EGFR mutations. 3) To assess the treatment response, time to progression and overall survival, in patients with and without EGFR mutations.
  • 5. Sample Size Sample size is calculated at 95% confidence level assuming 30% prevalence of EGFR mutations in non-small cell lung cancer patients as found in seed article Bharadwaj R et al. 2016). At the absolute allowable error of 10%, 84 cases of non-small cell lung cancer are required for sample size which is further enhanced and rounded off to 90 cases as final sample size, expecting 10% attrition or loss to follow up.
  • 6. Methodology A total of 90 tissue sample of NSCLC patients will be collected attending OPD & IPD at SMS Medical College & attached Hospital, Jaipur. Clinical data in the form of age, gender, smoking status, occupation, local residence, family history of cancer will be obtained from clinical records Radiological details particularly CT chest findings at presentation will be noted and images archived in a database Lung Biopsy with histopathological examination and IHC study.. DNA extraction from tissue samples by using FFPE kit as per manufactures instructions. DNA quality check by using a Nanodrop . Real Time PCR for clinically relevant EGFR mutations by using Qiagen thera screen EGFR RGQ PCR Kit .EGFR Mutation assay will be done along with the positive control and no template control (NTC). The analysis will be performed according to the manufacturers instructions and data will be analyzed by looking at CT (Cycle of the threshold) values.
  • 7. Flow chart Sample collection 90 cases of NSCLC patients Lung Biopsy (Histomorphology and IHC ) DNA Extraction from FFPE EGFR Mutation by using Real Time PCR Data Analysis Inclusion criteria Exclusion criteria Non Small cell Lung Cancer Inference
  • 8. Expected outcomes We expect to understand the prevalence of EGFR mutations and its contribution to lung cancer. Detection of these mutations would help in the effective prediction of response to EGFR-TKIs and also would help to detect the presence of secondary mutations that could alter the response of the patients to drugs. Novelty of the study: Our study will highlight the prevalence of EGFR mutations in Lung cancer in Rajasthan for the first time. This will help in outlining a systematic treatment protocol for such patients.
  • 9. Budget for the study S.No. Items Quantity Approx. Price 1 FFPE Tissue extraction kit 2 kits (50test each) Rs.1,00,000 2 RGQ Real Time PCR kit 3 kits (24rxns each) Rs 3,00,000 3 Misllaneous Items Rs 50,000 Total Rs 4,50,000/-