Peptide Nucleic Acid Clamping and Direct Sequencing in the Detection of Oncogenic Alterations in Lung Cancer: Systematic Review and Meta-Analysis.
PURPOSE
Molecular testing in non-small cell lung cancer (NSCLC) aids in identifying oncogenic alterations. The aim of this study was to compare the rates of detection of oncogenic alterations and responsiveness to epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) according to EGFR mutation status as determined by peptide nucleic acid (PNA) clamping or direct sequencing (DS).


MATERIALS AND METHODS
We performed a systematic literature search using MEDLINE, EMBASE, and the Cochrane Central Register. Data from included studies were pooled to yield summary sensitivity, specificity, positive and negative likelihood ratios, diagnostic odds ratio, and receiver operating characteristic curves. A meta-regression analysis was conducted to identify potential sources of heterogeneity between selected studies.


RESULTS
We identified 10 studies comprising 924 patients. Oncogenic alterations were detected in 340 of 924 cases (36.8%) with PNA clamping and in 250 of 924 (27.1%) with DS. The pooled sensitivities of PNA clamping and DS were 0.93 [95% confidence interval (CI): 0.90-0.95] and 0.69 (95% CI: 0.64-0.73), respectively. According to meta-regression analysis, none of the covariates were found to be significant sources of heterogeneity. With respect to treatment responses to EGFR-TKIs, there was no significant difference therein between EGFR mutations detected by PNA clamping and DS (53.4% vs. 50.8%; risk ratio, 0.99; 95% CI 0.83-1.19; p=0.874).


CONCLUSION
We demonstrated that PNA clamping has a higher sensitivity than DS for detecting oncogenic alterations in NSCLC. Our findings suggest that PNA clamping is a more useful method for clinical practice.
['Song|Jae Uk|JU|https://orcid.org/0000-0003-4597-7037', 'Lee|Jonghoo|J|https://orcid.org/0000-0003-2626-7099']
D000970:Antineoplastic Agents D002289:Carcinoma, Non-Small-Cell Lung D003250:Constriction D066246:ErbB Receptors D006801:Humans D008175:Lung Neoplasms D025202:Molecular Diagnostic Techniques D009154:Mutation D020135:Peptide Nucleic Acids D047428:Protein Kinase Inhibitors D020794:Receptor Protein-Tyrosine Kinases D012680:Sensitivity and Specificity D017421:Sequence Analysis D017422:Sequence Analysis, DNA D014178:Translocation, Genetic
peptide nucleic acids epidermal growth factor Genetic testing lung neoplasms