Front-line liquid biopsy for early molecular assessment and treatment of hospitalized lung cancer patients.

Autor: Parisi F; Medical Oncology 2 Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy., De Luca G; Molecular Diagnostic Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy., Mosconi M; Molecular Diagnostic Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy., Lastraioli S; Molecular Diagnostic Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy., Dellepiane C; Medical Oncology 2 Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy., Rossi G; Medical Oncology 2 Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy., Puglisi S; Medical Oncology 2 Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy., Bennicelli E; Medical Oncology 2 Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy., Barletta G; Medical Oncology 2 Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy., Zullo L; Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy., Santamaria S; Lung Cancer Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy., Mora M; Pathological Anatomy Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy., Ballestrero A; Department of Internal Medicine and Medical Specialties, University of Genoa, Italy; Academic Internal Medicine with Oncology Focus Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy., Montecucco F; Department of Internal Medicine and Medical Specialties, University of Genoa, Italy., Bellodi A; Academic Internal Medicine with Oncology Focus Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy., Del Mastro L; Department of Internal Medicine and Medical Specialties, University of Genoa, Italy; Academic Oncology Unit; IRCCS Ospedale Policlinico San Martino, Genoa, Italy., Lambertini M; Department of Internal Medicine and Medical Specialties, University of Genoa, Italy; Academic Oncology Unit; IRCCS Ospedale Policlinico San Martino, Genoa, Italy., Barisione E; Interventional Pulmonology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy., Cittadini G; Oncologic and Interventional Radiology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy., Tagliabue E; Interventional Pulmonology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy., Spagnolo F; Medical Oncology 2 Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy; Department of Integrated Surgical and Diagnostic Sciences (DISC), University of Genoa, Italy., Tagliamento M; Department of Internal Medicine and Medical Specialties, University of Genoa, Italy; Academic Oncology Unit; IRCCS Ospedale Policlinico San Martino, Genoa, Italy., Coco S; Lung Cancer Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy., Dono M; Molecular Diagnostic Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy., Genova C; Department of Internal Medicine and Medical Specialties, University of Genoa, Italy; Academic Oncology Unit; IRCCS Ospedale Policlinico San Martino, Genoa, Italy. Electronic address: carlo.genova@hsanmartino.it.
Jazyk: angličtina
Zdroj: Cancer treatment and research communications [Cancer Treat Res Commun] 2024 Aug 23; Vol. 41, pp. 100839. Date of Electronic Publication: 2024 Aug 23.
DOI: 10.1016/j.ctarc.2024.100839
Abstrakt: Background: Molecular characterization is pivotal for managing non-small cell lung cancer (NSCLC), although this process is often time-consuming and patients' conditions might worsen while molecular analyses are processed. Our primary aim was to evaluate the performance of "up-front" next-generation sequencing (NGS) through liquid biopsy (LB) of hospitalized patients with newly detected lung neoplasm in parallel with conventional diagnosis. The secondary aim included longitudinal monitoring through LB of patients with oncogenic alterations at baseline.
Methods: We enrolled 47 consecutive patients immediately after hospitalization and radiological detection of symptomatic lung neoplasm. LB from peripheral blood was performed at baseline, in parallel with conventional biopsy (CB), when feasible. Additionally, LBs were repeated during treatment in patients with actionable gene alterations at baseline. Oncomine™ Lung cfTNA Research Assay panel was employed for processing plasma samples in NGS.
Results: 47 hospitalized patients were enrolled. LB identified 28 patients with gene alterations, including mutations of EGFR (n = 7), KRAS (n = 12), ERBB2 (n = 1), TP53 (n = 2), BRAF (n = 1), one ALK rearrangement, and 4 patients with combined mutations involving EGFR, KRAS and PIK3CA. LB and CB were consistent, except for two patients. Three patients with positive LB for oncogenic drivers did not undergo CB due to contraindications. Median time to molecular results after LB was significantly lower compared to time to molecular report after CB (11 versus 22 days, p < 0.001).
Conclusions: Despite limited numbers, our study supports the role of front-line LB for improving management of symptomatic patients with lung cancer, potentially leading to early targeted therapy initiation.
Competing Interests: Declaration of competing interest Chiara Dellepiane has received honoraria for consulting activities of Astra Zeneca, Merck Sharp and Dohme, Bristol-Myers-Squibb, Roche. Francesco Spagnolo has been an advisory boards member for MSD, Novartis, Pierre Fabre, Sun Pharma, Philogen and has received lecture fees/honoraria for consulting activities of BMS, MSD, Novartis, Pierre Fabre, Merck, Sanofi, Sun Pharma, IGEA. Matteo Lambertini reports advisory role for Roche, Lilly, Novartis, Astrazeneca, Pfizer, Seagen, Gilead, MSD and Exact Sciences and speaker honoraria from Roche, Lilly, Novartis, Pfizer, Sandoz, Libbs, Daiichi Sankyo, Knight and Takeda, Travel Grants from Gilead and Daiichi Sankyo, and research support (to the Institution) from Gilead outside the submitted work. Lucia Del Mastro has received honoraria for consulting activities, speaker bureau or advisory boards from Roche, Novartis, Pfizer, Eli Lilly, Astra Zeneca, Merck-Sharp-Dohme, Seagen, Gilead, Pierre Fabre, Eisai, Exact sciences, Ipsen, GSK, Agendia, Stemline Menarini, Daiichi Sakyo. Carlo Genova has received honoraria for consulting activities, speaker bureau or advisory boards from Astra Zeneca, Bristol-Myers-Squibb, Eli Lilly, Janssen, Merck Sharp and Dohme, Novartis, Roche, Sanofi, Takeda. The other authors declare no conflicts of interest.
(Copyright © 2024. Published by Elsevier Ltd.)
Databáze: MEDLINE
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