Gene Expression Profiling of EGFR, FGFR2, PIK3CA, PTEN, SMAD4, STK11, and TP53 in Cell-Free RNA From Exhaled Breath Condensate: Diagnostic, Prognostic, and Therapeutic Implications in Advanced Lung Adenocarcinoma.
Summary
This prospective study evaluated gene expression profiling of seven genes (EGFR, FGFR2, PIK3CA, PTEN, SMAD4, STK11, TP53) in cell-free RNA (cfRNA) from exhaled breath condensate (EBC) in patients with advanced lung adenocarcinoma. Results indicated that PIK3CA showed the best diagnostic performance in distinguishing patients from healthy controls. High expression of FGFR2 and PIK3CA was associated with significantly shorter overall survival, highlighting their prognostic relevance. EGFR expression demonstrated a strong correlation between EBC and plasma, and low EGFR expression was linked to longer survival in patients receiving chemotherapy alone. This non-invasive EBC-based approach offers potential for molecular characterization and patient stratification.
Analysis
This study is highly relevant for translational research and clinical practice in lung oncology. The use of exhaled breath condensate (EBC) as a non-invasive source of biomarkers represents a significant advancement, potentially complementing or replacing invasive tissue biopsies. The identification of PIK3CA as a diagnostic marker, FGFR2 and PIK3CA as prognostic markers, and EGFR with predictive value for chemotherapy, could improve patient stratification and guide therapeutic decisions. This paves the way for earlier diagnostics, less burdensome monitoring, and precision medicine for advanced lung adenocarcinoma.