The cobas® EGFR Mutation Test v2 is a real-time PCR test for the qualitative detection of defined mutations of the epidermal growth factor receptor (EGFR) gene in non-small cell lung cancer (NSCLC) patients. Defined EGFR mutations are detected using DNA isolated from formalin-fixed paraffin-embedded tumor tissue (FFPET) or circulating-free tumor DNA (cFDNA) from plasma derived from EDTA anti-coagulated peripheral whole blood.
The test is indicated as a companion diagnostic to aid in selecting NSCLC patients for treatment with the targeted therapies listed in Table 1 below in accordance with the approved therapeutic product labeling
Drug |
FFPET |
Plasma |
TARCEVA® (erlotinib) |
Exon 19 deletions and L858R |
Exon 19 deletions and L858R
|
TAGRISSO™ (osimertinib)
|
T790M |
TT790M* |
Patients with positive cobas® EGFR Mutation Test v2 test results using plasma specimens for the presence of the EGFR mutations listed above are eligible for treatment with the corresponding drug as indicated in Table 1 (see Note* for T790M). Patients who are negative for these mutations by this test should be reflexed to routine biopsy and testing for EGFR mutations with the FFPET sample type.
*The efficacy of TAGRISSO™ (osimertinib) has not been established in EGFR T790M plasma-positive, tissue-negative or unknown population and clinical data for T790M plasma-positive patients are limited; therefore testing using plasma specimens is most appropriate for consideration in patients from whom a tumor biopsy cannot be obtained.
Drug safety and efficacy have not been established for the following EGFR mutations also detected by the cobas® EGFR Mutation Test v2:
Drug |
FFPET |
Plasma |
TARCEVA® (erlotinib)
|
G719X, exon 20 insertions,
T790M,S768I and L861Q
|
G719X, exon 20 insertions,
T790M, S768I and L861Q |
TAGRISSO™ (osimertinib)
|
G719X, exon 19 deletions,
L858R, exon 20 insertions,
S768I, and L861Q
|
G719X, exon 19 deletions,
L858R, exon 20 insertions,
S768I, and L861Q
|
For manual sample preparation, FFPET specimens are processed using the cobas® DNA Sample Preparation Kit and plasma specimens are processed using the cobas® cfDNA Sample Preparation Kit. The cobas z 480 analyzer is used for automated amplification and detection.