Thoracic small tissue specimens for comprehensive genomic profiling adequately provide predictive information for the current guideline-recommended biomarkers for non-small cell lung cancer (NSCLC; J Clin Pathol. 2021 May; jclinpath-2021-207597. doi:10.1136/jclinpath-2021-207597).
“In advanced-stage [NSCLC], incomplete genotyping for guideline-recommended genomic biomarkers poses a significant challenge to making informed and timely clinical decisions,” writes Erin Faber, DO, Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, and colleagues.
This study assessed the adequacy of small specimens for comprehensive genomic profiling of guideline-recommended lung cancer biomarker testing. Adequacy was defined as successful testing of guideline-recommended biomarkers.
Image-guided procedures for NSCLC performed at The University of Texas MD Anderson Cancer Center were evaluated between October 2016 and July 2018. The included procedures were core needle biopsy and fine-needle aspiration.
A total of 865 cases were evaluated, 785 of which had an evaluation of all lung cancer biomarkers. These biomarkers included EGFR, BRAF, ALK, ROS1, RET, MET, and PD-L1.
Adequacy of lung tissue for biomarker testing increased from 84% to 87% when biomarker testing was combined with concurrently acquired fine needle aspiration or core needle biopsy specimens. Success rates were significantly higher for biomarker testing of core needle biopsy specimens compared to fine needle aspiration specimens (P = .0005).
“The growing numbers of therapeutic biomarkers in NSCLC requires judicious triage of limited-volume tissue from small specimens” concluded Dr Faber and colleagues, adding “Our study showed that thoracic small tissue specimens can be used successfully to provide prognostic and predictive information for the current guideline-recommended biomarkers for NSCLC in most cases.”—Marta Rybczynski
