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S.H. Sabir



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    P1.03 - Poster Session with Presenters Present (ID 455)

    • Event: WCLC 2016
    • Type: Poster Presenters Present
    • Track: Radiology/Staging/Screening
    • Presentations: 3
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      P1.03-004 - Percutaneous Lung Biopsy for Genomic Assessment: Comparison between Two Different next Generation Sequencing Platforms (ID 6291)

      14:30 - 15:45  |  Author(s): S.H. Sabir

      • Abstract

      Background:
      Purpose: Compare the successful use of percutaneous lung biopsy for two different next generation sequencing (NGS) platforms.

      Methods:
      Retrospective review of 232 consecutive lung cancer patients who underwent a histologically diagnostic image guided lung biopsy for NGS between 4/2013 and 12/2014 with samples sent for NGS. Procedures were performed using 19 gauge coaxial guide needles, 20 gauge side-cutting core needles and 22 gauge Chiba FNA needles. If a request for analysis of 2 or more gene mutations was received, samples were evaluated for NGS. A minimum sample tumor cellularity of 20% on pathology review was required to send for NGS. Next DNA was extracted from the samples and amount of DNA was assessed. Sequencing was performed with a 46-gene or 50-gene multiplex platform (Iron Torrent Personal Genome Machine). Patient demographics, lesion imaging, procedural technique and NGS success were collected. Descriptive statistics were tabulated. Two tailed Fisher’s exact test was calculated to compare success rate of the two NGS platforms.

      Results:
      The average age of the patients was 66 years (34 – 91). 59.05% were female, 65.52% had history of smoking, 89.22% of the tumors biopsied were primary lung cancer and 10.78% were lung metastasis from lung cancer. Average lesion size was 4.07 cm (0.8 – 15.6). 84.91% of the lesions were spiculated, 78% were solid and 4.74% had calcification. 20.69% of the patients had pleural effusion, 65.08% had known metastasis and 20.25% had systemic treatment within three months prior to the procedure. Average lesion distance from the pleura was 1.87 cm (0 to 8.5 cm). 48.70% of the biopsies had local hemorrhage during the procedure, 18.10% developed pneumothorax and 5.17% needed a chest tube. 44 biopsies were collected for NGS with 46-gene multiplex platform (CMS-46) and 188 for 50-gene (CMS-50) assessment. The success rate was 59.09% for CMS-46 and 80.85% for CMS-50 (p=0.0048).

      Conclusion:
      There is a significant difference in the successful use of percutaneous lung biopsy with two different NGS platforms.

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      P1.03-014 - Value of Performing Fine Needle Aspiration with Core Biopsy for Genomic Mutation Assessment in Percutaneous Lung Biopsies (ID 6324)

      14:30 - 15:45  |  Author(s): S.H. Sabir

      • Abstract

      Background:
      Personalized care of lung cancer patients requires determination of targetable genetic mutations. This study was performed to investigate the added value of performing fine needle aspiration (FNA) with core biopsy in percutaneous lung biopsy to assess clinically relevant genomic mutations in EGFR, KRAS and BRAF. ALK mutation was assessed separately through FISH, which was not assessed in this study.

      Methods:
      Retrospective analysis of all CT-guided lung biopsies in lung cancer patients with samples sent for next generation sequencing (NGS) with a 50-gene multiplex panel during 2013 and 2014. Procedures were performed using 19 gauge coaxial guides, 20 gauge side-cutting core needles and 22 gauge Chiba needles. Samples were processed for histological evaluation. The remaining material was reviewed for adequate tumor cellularity (>20%) by pathology. If the specimen collected through core biopsy did not present adequate tumor cellularity, the FNA material was reviewed and sent for mutation analysis. DNA was extracted and sequenced with a 50-gene multiplex platform (Ion Torrent Personal Genome Machine). If the samples were not adequate for NGS, single gene sequencing was performed for the requested genetic mutations. Patient demographic, lesion imaging features, procedure technique and molecular results were collected. Descriptive statistics were tabulated.

      Results:
      A total of 188 patient met the criteria for this study. 184 patients had FNA and core biopsy together and 4 had only FNA. 19 out of 184 (10.32%) core biopsy specimen had <20% tumor cellularity and had FNA material sent for NGS. The average age was 66 years old, 57.44% of the patients were female and 65.42% had history of smoking. 29.78% had systemic treatment before the biopsy, 78.72% of the tumor were solid and the average lesion size was 3.9 cm (range 0.8 to 15.6 cm). The overall adequacy of core biopsy specimen for assessing requested genetic mutations was 78.80% (135 out of 184) and the adequacy of combined core biopsy and/or FNA specimen for assessing requested genetic mutations was 87.76% (152 out of 188).

      Conclusion:
      The addition of FNA to core during percutaneous lung biopsies done in lung cancer patients for assessment of actionable genetic mutations significantly increased the success rate from 78.89% to 87.76%.

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      P1.03-079 - Adequacy of Percutaneous Lung Biopsy for Assessing Clinically Requested Genetic Mutations in Lung Cancer (ID 6302)

      14:30 - 15:45  |  Author(s): S.H. Sabir

      • Abstract

      Background:
      Percutaneous lung biopsy is used to assess for the presence of actionable genetic mutations in EGFR, BRAF and KRAS. ALK mutation was assessed separately through FISH, which was not assessed in this study. Sequencing can be performed with next generation sequencing (NGS) or single gene sequencing (SGS).

      Methods:
      A retrospective study with 188 consecutive histologically diagnostic CT guided lung biopsies sent for NGS were performed between 2013 and 2014. Procedures were performed using 19 gauge guiding cannula, 20 gauge side-cutting core needles and 22 gauge Chiba FNA needles. Patients in whom 2 or more gene mutation analyses were requested had their biopsy specimen analyzed for adequate tumor cellularity (>20% tumor) and if adequate had DNA extracted and sequenced with a 50-gene multiplex platform (Ion Torrent Personal Genome Machine). If the material was not adequate for NGS, the requested genes mutation analyses were performed with SGS. Demographics, procedure technique as well as lesion features were collected. Descriptive statistics were tabulated and chi-square statistical analysis performed.

      Results:
      57.44% of the patients were female, with average age of 67 years (35-91) and 65.42% had history of smoking. Lesion size varied from 0.8 cm to 15.6 cm, with average of 3.9 cm. 83.51% were spiculated, 78.72% solid, 12.23% presented intralesional low attenuation (<20HU), 11.17% were associated with perilesional atelectasis and 19.14% with pleural effusion. 63.83% had known metastasis at the time of the procedure, 29.78% had systemic treatment before the biopsy. Specimens were successfully used for NGS in 80.52% of cases. Overall adequacy of biopsy specimens for analysis of gene mutations requested was 87.76%.

      Conclusion:
      The overall success rate of percutaneous image guided lung cancer biopsies for clinically requested genetic mutation analysis was 87.76%.