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CompletedNCT07475637LBM-T790MUpdated Mar 19, 2026

Liquid Biopsy Monitoring Of EGFR T790M in Advanced Non-Small Cell Lung Cancer

An observational study in Non-Small Cell Lung Cancer, sponsored by Faculty of Medicine of Tunis. Completed at 1 site in Tunisia. Per ClinicalTrials.gov, last updated 2026-03-19.

Sponsored by Faculty of Medicine of Tunis · Observational

Study type
Observational
Model
Case-only
Time perspective
Retrospective
Enrollment
70
Sex
All
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Study summary

The goal of this retrospective observational study is to assess the clinical utility of plasma-based EGFR testing for detection and longitudinal monitoring of the acquired T790M resistance mutation in patients with advanced EGFR-mutated non-small cell lung cancer (NSCLC) treated with first- or second-generation EGFR tyrosine kinase inhibitors in routine clinical practice in Tunisia.

The main questions it aims to answer are:

  • What is the detection rate of EGFR T790M mutation in plasma at the time of disease progression?
  • Does repeated liquid biopsy increase the cumulative detection of T790M?
  • Is T790M emergence associated with baseline clinical and molecular characteristics?
  • Is T790M status associated with progression-free survival? Participants underwent plasma sampling for circulating tumor DNA analysis during follow-up, and clinical and molecular data were retrospectively collected from medical records to evaluate mutation dynamics and outcomes.
Read the detailed description

Acquired resistance to first- and second-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) in advanced EGFR-mutated non-small cell lung cancer (NSCLC) is most commonly mediated by the secondary EGFR T790M mutation. Identification of this resistance mechanism is clinically relevant, as it may guide subsequent treatment strategies. However, repeat tissue biopsy at disease progression is often limited by tumor inaccessibility, patient condition, or procedural risk. Plasma-based analysis of circulating tumor DNA (ctDNA) offers a minimally invasive alternative for molecular reassessment.

This retrospective real-world study evaluates the implementation of plasma EGFR testing for the detection of acquired T790M mutation in routine clinical practice in Tunisia. The study focuses on the detection rate of T790M at progression, the added value of repeated liquid biopsy sampling in initially negative cases, and the relationship between T790M emergence and baseline clinical or molecular characteristics.

In addition, longitudinal patterns of T790M appearance, persistence, or loss across serial plasma samples are explored to better understand resistance dynamics under TKI selective pressure. The association between T790M status and progression-free survival is also assessed.

By integrating molecular results with longitudinal clinical follow-up, this study seeks to characterize real-world patterns of acquired resistance and to evaluate the practical contribution of plasma-based EGFR testing to therapeutic decision-making.

02

Conditions studied

  • Non-Small Cell Lung Cancer

Keywords

  • EGFR-mutated NSCLC
  • EGFR T790M
  • Liquid biopsy
  • Plasma EGFR testing
  • Circulating tumor DNA
  • Serial liquid biopsy
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In context

Carcinoma, Non-Small-Cell Lung

7,620 studies on the registry are indexed under Carcinoma, Non-Small-Cell Lung; 1,838 are open to participants now.

This study's enrollment of 70 is below the median of 160 across 1,148 observational studies indexed under Carcinoma, Non-Small-Cell Lung.

Browse Carcinoma, Non-Small-Cell Lung studies →

Lead sponsor

Faculty of Medicine of Tunis is the lead sponsor of 5 studies on the registry; 4 are open to participants now.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
Child (0–17), Adult (18–64), Older adult (65+)
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

This study included patients with advanced non-small cell lung cancer consulting in different hospitals in Tunisia (The Military Hospital of Tunis, Salah Azaiez Institute, Abderhamen Mami Hospital, Jendouba Hospital, Charles Nicolle Hospital of Tunis...) and referred to the Pathology Department of Charles Nicolle Hospital of Tunis for EGFR T790M monitoring using liquid biopsy.

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Confirmed advanced (stage IIIB/IV) non-small cell lung cancer
  • Documented activating EGFR mutations
  • Disease progression on first- or second-generation EGFR TKIs

Exclusion criteria

Exclusion Criteria:

  • Prior treatment with third-generation EGFR TKIs before plasma sampling
  • Lack of follow-up clinical data
05

Study design

Observational model
Case-only
Time perspective
Retrospective
Enrollment
70 participants (actual)
Patient registry
No
Biospecimen retention
Samples with dna
06

What researchers measure

Primary outcomes

  1. Detection rate of EGFR T790M mutation in plasma at disease progression

    Proportion of patients with detectable T790M in plasma at the time of radiological progression.

    Time frame: From initiation of first- or second-generation EGFR-TKI therapy until the first documented radiological disease progression at which plasma EGFR T790M testing is performed, assessed up to 36 months.

  2. Proportion of participants with newly detected EGFR T790M on repeat liquid biopsy after an initial negative plasma result

    Incremental T790M detection rate in patients with initially negative plasma results who underwent additional testing.

    Time frame: From the initial negative plasma EGFR T790M result at radiological disease progression until detection of T790M on repeat liquid biopsy testing during follow-up, assessed up to 36 months.

Secondary outcomes

  1. Association of T790M emergence with baseline characteristics

    Correlation of T790M status with clinical and molecular features at baseline.

    Time frame: Baseline defined at the time of initiation of first- or second-generation EGFR-TKI therapy, before treatment exposure

  2. Progression-free survival by T790M status

    Comparison of progression-free survival in patients with versus without T790M detected in plasma.

    Time frame: From initiation of first- or second-generation EGFR-TKI therapy until the first radiologically confirmed disease progression, assessed up to 36 months.

07

Study locations

1 site
  • Pathology Department, Charles Nicolle Hospital of Tunis
    Tunis, 1007, Tunisia
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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Mar 19, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT07475637
Lead sponsor
Faculty of Medicine of Tunis
Collaborators
Hopital Charles Nicolle
Responsible party
Soumaya RAMMEH (Professor, Faculty of Medicine of Tunis) — Principal investigator
First posted
Mar 16, 2026
Start date
Mar 1, 2023
Primary completion
Dec 30, 2025
Completion
Dec 30, 2025
Last update
Mar 19, 2026

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Mar 2026. You cannot join it, but the record below documents what was studied.

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