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Super-ARMS and ddPCR share the similar accuracy for EGFR mutation detection in plasma biopsy; both methods predicted well the efficacy of EGFR-TKIs by detecting plasma EGFR status.

Detection of EGFR mutations in ctDNA is an effective method to identify patients who might beneft from frst-line geftinib treatment. Further analyses of dynamic alterations of EGFR mutations and accompanying gene aberrances could predict resistance to geftinib.

SuperARMS is a promising plasma-based assay for EGFR mutations, including T790M. It might be useful in advanced-stage lung adenocarcinoma patients whose tissue biopsy samples are insufficient for a traditional diagnostic EGFR assay or for patients with a poor performance status.

In conclusion, the results from this prospective study indicated the important clinical impact of T790 M detection using plasma samples for NSCLC patients who failed after EGFR-TKI therapy. Well concordance among three assays indicated the feasibility of plasma ctDNA detection. The ddPCR assay had a high sensitivity and might be superior to ARMS and SuperARMS assays.

ADx-SuperARMS EGFR assay is likely to be a highly sensitive and specific method to noninvasively detect plasma EGFR mutations of patients with advanced lung adenocarcinoma. The EGFR mutations detected by ADx-SuperARMS EGFR assay could predict the efficacy of the treatment with first generation of EGFR-TKIs. Hence, EGFR blood testing with ADxSuperARMS could address the unmet clinical needs.

Histological tissues are preferred for anaplastic lymphoma kinase(ALK)  fusion detection in non-small cell lung cancer(NSCLC). The aim of this study was to evaluate the feasibility of cytological sample as an alternative specimen for ALK fusion  testing in patients with advanced NSCLC.