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M. Febvre

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    P1.03 - Poster Session 1 - Technology and Novel Development (ID 150)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Biology
    • Presentations: 1
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      P1.03-005 - High throughput array and sensitive mass spectrometry technology applied to Transbronchial Needle Aspiration allow the (detection of hundreds molecular targets) tumor profiling for routine care personalized medicine (ID 2432)

      09:30 - 16:30  |  Author(s): M. Febvre

      • Abstract

      The personalized therapies against specific genetic targets in tumoral cells like EGFR mutations or EML-ALK translocation, or the development of minimized invasive procedures for diagnosis and cancer staging have dramatically improved the outcome of patients with lung cancer. The combination of the wide use of Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration (EBUS-TBNA) and genetic testing to individually tailor chemotherapy should become the standard of care. However, the rapid evolution of personalized medicine is toward the routine testing of high number of biomarkers per patient. Therefore, we have tested whether the recently developed DNA arrays and multiplex technologies could increase the suitability of very small size biopsies performed by EBUS-TBNA for the high-throughput molecular diagnosis

      Fourty consecutive EBUS TBNAs with histologically diagnosed lung adenocarcinoma were tested using the high throughput array and sensitive mass spectrometry technology (Massarray, Sequenom) for the detection of 216 mutations in 26 cancer genes (Lungcarta).Each of the 40 DNAs extracted from only one 19- to 22-gauge needle aspiration spread on a glass slide per patient has been successfully amplified and analyzed within one-day experiment for all of the 238 mutations

      Five patients (12.5 %) exhibited EGFR mutations and received either gefitinib or erlotinib, 1 of them exhibiting the T790M resistance mutation. One patient had the BRAFV600E mutation confirmed 1-y later on a skin metastasis and thus entered a phase II trial to receive anti-BRAF therapy. There were EBUS-TBNA exhibiting mutations in KRAS (n=7), PI3K (n=1) and cMET (n=1), and insertion in HER2 (n=2).

      In conclusion, only one 19-22 gauge needle aspiration is suitable in routine care for the detection of at least 238 mutations, to guide treatment decisions and offer patients to benefit from current and future individually targeted drugs