| Popis: |
Introduction: Re-biopsy seems to provide information on tumor biology in advanced and progressive Non-Small-Cell Lung Cancer (NSCLC) after first line treatment. Our study aims to investigate complications, feasibility, and clinical relevance of systematic re-biopsy from suspicious lesion. Methods: Patients with non-targetable advanced NSCLC receiving first line systemic treatment were included in a prospective non-interventional single-center study (NCT03512847). At baseline, a diagnostic biopsy was performed and at the time of progressive disease, a tumor biopsy was performed preferentially from progressive lesions for histologic analysis and Programmed Death Ligand 1 (PD-L1) status. The primary endpoint was complication rate to re-biopsy and secondary endpoint was feasibility, and clinical relevance defined as treatment change due to change in PD-L1 status. Results: We enrolled 89 patients with advanced NSCLC from June 2018 to December 2019. Of the 52 patients with progressive disease, 37 were referred for re-biopsy with 100% success rate. The primary sites of progression and re-biopsy were lungs (54%) and thoracic lymph nodes (30%). Percutaneous needle aspiration (35%) was the preferred modality of biopsy, followed by endoscopic ultrasound via airways (EBUS) (27%) or esophagus (EUS) (24%). Complication rate was 8% (3 patients) represented by pneumothorax, hydropneumothorax and pneumonia. We observed a change in PD-L1 status in 10 patients (27%), and clinically relevant changes in 9 patients (24%) including no malignant cells in 3 patients. Conclusion: Our study demonstrates that re-biopsy is feasible, safe and clinically relevant in patients with suspected progression in advanced NSCLC. |
