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Junghoon Kim
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P2.03 - Chemotherapy/Targeted Therapy (ID 704)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Chemotherapy/Targeted Therapy
- Presentations: 1
- Moderators:
- Coordinates: 10/17/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P2.03-018 - Diagnostic Yield of Fine-Needle Aspiration and Core-Needle Biopsy in Assessment of EGFR and ALK Mutation Status in Non–Small Cell Lung Cancer (ID 8545)
09:30 - 16:00 | Presenting Author(s): Junghoon Kim
- Abstract
Background:
The identification of specific molecular drivers of pathogenesis is now crucial for treatment with targeted therapies in NSCLC. It is reported that ALK-rearrangement shows an intratumor heterogeneity in mixed adenocarcinomas and adenosquamous carcinomas, while EGFR-mutation is generally homogeneously expressed. Because of this intratumor heterogeneity, there is concern about underestimation of molecular markers in biopsy. Thus, we compared the diagnostic yields of fine-needle aspiration (FNA), core-needle biopsy (CNB), and surgical resection sample for EGFR-mutation and ALK-rearrangement.
Method:
This retrospective study was approved by institutional review boards, and informed consent was waived. Diagnostic yields of EGFR-mutation pyrosequencing tests and ALK-rearrangement FISH studies performed during a 6 year period (Jan 2010 - Dec 2016) were investigated stratified by the 3 tissue sampling methods: FNA, CNB and surgical resection. The diagnostic yields of positive results of EGFR-mutation and ALK-rearrangement tests were compared according to the tissue sampling methods.
Result:
Among the 1617 EGFR-mutation pyrosequencing tests, the number of surgical resection sample, CNB, and FNA was 996, 262, and 359, respectively, and the positive results were 41.7% (95% confidence interval 38.6–44.8), 40.8% (35.1–46.9), 38.2% (33.3–43.2), respectively. On the other hand, in a total of 221 ALK-rearrangement FISH studies, positive results of surgical resection sample (n = 60), CNB (n = 87), FNA (n = 74) were 45% (95% confidence interval 33.1–57.5), 44.8% (34.8–55.2), 31.1% (21.7–42.3), respectively.
Conclusion:
Diagnostic yields of FNA, CNB and surgical resection samples were not significantly different in EGFR-mutation pyrosequencing tests, and this probably reflects known intratumor homogeneity of EGFR-mutation. In the ALK-rearrangement FISH study, the diagnostic yield of FNA was lower than that of surgical resection or CNB samples. This difference is presumably due to intratumor heterogeneity, and caution should be made as it may cause underestimation of ALK-rearrangement in biopsy samples.
