Methods and compositions to detect mutations in plasma using exosomal rna and cell free dna from non-small cell lung cancer patients

A method for treating lung cancer in a subject in need thereof comprising:

• (a) extracting at least one nucleic acid from at least one microvesicle isolated from a biological sample from the subject;
• (b) detecting the amount of at least one Epidermal Growth Factor Receptor (EGFR) variant in the at least one extracted nucleic acid, wherein the at least one EGFR variant comprises EGFRT790M, EGFRL858R, EGFR comprising at least one exon19 insertion, EGFR comprising at least one exon 19 deletion or any combination thereof,
• (c) comparing the amount of the at least one EGFR variant to at least one pre-defined cutoff threshold;
• (d) administering to the subject at least one anti-cancer therapy when the amount of the at least one EGFR variant is greater than or equal to the at least pre-defined cutoff threshold.

A method for treating lung cancer in a subject in need thereof comprising:

• (a) extracting at least one nucleic acid from at least one microvesicle isolated from a biological sample from the subject;
• (b) isolating at least one circulating nucleic acid from the biological sample;
• (c) detecting the amount of at least one Epidermal Growth Factor Receptor (EGFR) variant in the at least one extracted nucleic acid and the at least one isolated circulating nucleic acid, wherein the at least one EGFR variant comprises EGFRT790M, EGFRL858R, EGFR comprising one or more exon19 insertions, EGFR comprising one or more exon 19 deletions or any combination thereof,
• (d) comparing the amount of the at least one EGFR variant to at least one pre-defined cutoff threshold;
• (e) administering to the subject at least one anti-cancer therapy when the amount of the at least one EGFR variant is greater than or equal to the at least pre-defined cutoff threshold.