Clinical Utility of a Circulating Tumor Cell-Based Cerebrospinal Fluid Assay in the Diagnosis and Molecular Analysis of Leptomeningeal Disease in Patients With Advanced Non-Small Cell Lung Cancer.

Autor:	Malhotra J; Department of Medical Oncology and Therapeutics Research, City of Hope, Duarte, CA., Muddasani R; Department of Medical Oncology and Therapeutics Research, City of Hope, Duarte, CA., Fricke J; Department of Medical Oncology and Therapeutics Research, City of Hope, Duarte, CA., Mambetsariev I; Department of Medical Oncology and Therapeutics Research, City of Hope, Duarte, CA., Reyes A; Department of Medical Oncology and Therapeutics Research, City of Hope, Duarte, CA., Babikian R; Department of Medical Oncology and Therapeutics Research, City of Hope, Duarte, CA., Dingal ST; Department of Medical Oncology and Therapeutics Research, City of Hope, Duarte, CA., Kim P; Department of Pharmacy, City of Hope, Duarte, CA., Massarelli E; Department of Medical Oncology and Therapeutics Research, City of Hope, Duarte, CA., Feldman L; Department of Surgery, City of Hope, Duarte, CA., Chen M; Department of Surgery, City of Hope, Duarte, CA., Afkhami M; Department of Pathology, City of Hope, Duarte, CA., Salgia R; Department of Medical Oncology and Therapeutics Research, City of Hope, Duarte, CA.
Jazyk:	angličtina
Zdroj:	JCO precision oncology [JCO Precis Oncol] 2024 Dec; Vol. 8, pp. e2400373. Date of Electronic Publication: 2024 Dec 12.
DOI:	10.1200/PO-24-00373
Abstrakt:	Purpose: Leptomeningeal disease (LMD) is associated with significant morbidity and mortality for metastatic non-small cell lung cancer (NSCLC). We describe our clinical experience in evaluating the use of cerebrospinal fluid (CSF)-derived circulating tumor cells (CTCs) for the diagnosis of LMD and the detection of genomic alterations in CSF cell-free DNA (cfDNA). Methods: Patients with NSCLC who had CSF collection as part of routine clinical care for suspected LMD were included in the study. CSF was evaluated for CTCs and cfDNA using a commercial assay (CNSide; Biocept, San Diego, CA), and molecular profiling was performed. Molecular testing results from sequencing of tumor tissue and plasma circulating tumor DNA were collected. cMET and human epidermal growth factor receptor 2 (HER2) expression analysis was performed using fluorescence in situ hybridization (FISH). Results: Twenty-two patients were included (77% female; median age 60 years). Sixty-four percent had sensitizing EGFR mutations, and 32% had an atypical EGFR mutation. Thirteen of the 22 patients (59%) were diagnosed with LMD using the CSF CTC assay. Five of these 13 patients (38%) had negative CSF cytology for LMD, and two patients (15%) had normal magnetic resonance imaging brain imaging. Seven of the 13 patients (54%) had sufficient CTCs to perform molecular profiling. The concordance with tissue next-generation sequencing was 100%, and the driver mutation was identified in all seven patients with the CSF cfDNA assay. cMET expression and HER2 expression via FISH were noted in 11 patients (50%) and four patients (18%) respectively. Conclusion: We detected higher sensitivity to diagnose LMD using CSF CTC-based assay; 38% of LMD cases identified using this assay were missed by standard CSF cytology. CSF molecular testing using CSF cfDNA demonstrated high concordance with tissue-based molecular testing.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu