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In East Asia, epidermal growth receptor factor (EGFR) mutations are the most prevalent and important biomarkers for treating patients with advanced lung cancer. However, as L858R doublet mutations are rare, commercially available EGFR tests may yield false-negative results. To determine whether the L858R mutation of the L858R-K860I and L858R-L861F doublet mutations could be identified using different types of EGFR detection tests and to describe the clinical response of patients with lung cancer with L858R doublet mutations to EGFR tyrosine kinase inhibitors (TKI). Information and samples from four patients with L858R doublet mutations, including three with L858R-K860I and one with L858R-L861F, were retrospectively collected from the archives of our department. For each case, the clinical response to EGFR-TKI was retrieved from the medical records. Archived formalin-fixed paraffin-embedded blocks were subjected to Sanger sequencing, the cobas and Idylla EGFR tests, the IntelliPlex-LCP-DNA assay, and AmoyDx PLC panel. L858R mutations were all detected by Sanger sequencing and the Idylla EGFR test but missed by the cobas assay. The AmoyDx PLC detected L858R only in cases with L858R-K860I while the IntelliPlex-LCP-DNA assay detected L858R in the case with L858R-L861F. Additionally, three of the patients, who had measurable tumors, showed partial responses to afatinib and osimertinib. The L858R mutation associated with L858R-K860I and L858R-L861F doublet mutations could be detected using Idylla but not cobas EGFR tests. Using next-generation sequencing analysis should be considered after initial negative reports from the cobas test, because patients with L858R doublet mutations may benefit from EGFR-TKIs. [ABSTRACT FROM AUTHOR]

The early presence of crops from East Asia and Southwest Asia in the Inner Asian Mountain Corridor (IAMC) has drawn attention to the Bronze Age mountain archaeology of Central Asia. Namely, the Bronze Age diffusion and utilization of grains in this region remains unknown as contrasts and extremes characterize the territory in environmental terms, especially elevation. Researchers continue to reflect on how, during the second millennium BC, Bronze Age populations used new crops and local animal resources to adapt to different elevation environments of the IAMC. In this study, we analyzed the 41 latest stable carbon and nitrogen isotopic results from human and faunal bones from six Bronze Age sites in the IAMC, 261 previously published stable isotopic datasets, and 12 archaeobotanical and four zooarchaeological results to investigate the dietary strategies of populations from different elevation environments in the Bronze Age IAMC. The results show an altitudinal gradient in dietary choices among Bronze Age populations in the IAMC, with mixed C 4 and C 3 consumption at the low-mid elevations and notable C 3 consumption at the high elevations. Archaeobotanical and faunal remains also support these isotopic results. Our study further highlights that the differentiated dietary strategies adopted by the Bronze Age population in IAMC may have been the product of adaptation to local geographic environments. Social interaction may have also played a role in certain types of special dietary consumption. • We investigated the dietary strategies among Bronze Age population in the Inner Asian Mountain Corridor. • There is notable altitudinal difference in the consumption of crops including C 4 millet and C 3 wheat/barley. • There is also internal differences in crops consumption among population at high altitude. • Differentiated crops utilization strategy could be related with geographic environment and social factors. [ABSTRACT FROM AUTHOR]