High-Content Biopsies Facilitate Molecular Analyses and Do Not Increase Complication Rates in Patients With Advanced Solid Tumors.
High-Content Biopsies Facilitate Molecular Analyses and Do Not Increase Complication Rates in Patients With Advanced Solid Tumors.
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DOI：
10.1200/po.17.00081
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发表时间：
2017-11-01
影响因子：
4.6
通讯作者：
Weissleder, Ralph
中科院分区：
文献类型：
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作者：
Frenk, Nathan E;Spring, Laura;Weissleder, Ralph
目得：精确肿瘤学依赖于对肿瘤组织的频繁病理学、分子学和基因组学评估，以指导治疗选择、评估新型药物的药效学作用并确定耐药机制。较新的分析形式，如细胞系和患者来源的异种移植物中的药物筛选，需要越来越多的组织材料。它仍然是未知的，如何需要大量的肿瘤核心系列活检与组织产量和活检并发症rates.MATERIALS和METHODS：在这项研究中，我们进行了回顾性分析，199局灶性肝活检143例患者在设置肿瘤研究协议（研究活检组）超过4年的时间在一个单一的干预肿瘤服务。将实践模式和并发症发生率与在1，154例患者中进行的1，522次连续活检相关的情况进行比较，其中获得两个核心用于患者的标准临床管理（标准活检）。在研究活检组中，（平均，每次手术5.5个核心），并分发给试验申办者，内部研究实验室和病理学服务。该队列中严重并发症的并发症发生率为0.5%（1/199），保守治疗的轻微并发症发生率为1.0%（2/199）。在标准活检对照组中，1.4%的手术（1,522例中的22例）观察到严重并发症，0.2%的手术（1,522例中的3例）观察到轻微并发症。这些并发症发生率没有统计学差异。结论：通过同轴针收获额外的组织芯在局灶性肝活检不会增加并发症发生率，并产生有价值的组织进行额外的实验测试。
PURPOSE: Precision oncology relies on frequent pathologic, molecular, and genomic assessments of tumor tissue to guide treatment selection, evaluate pharmacodynamic effects of novel agents, and determine drug resistance mechanisms. Newer forms of analyses such as drug screens in cell lines and patient-derived xenografts demand increasing amounts of tissue material. It remains unknown how the need for serial biopsies with large numbers of tumor cores relates to tissue yields and biopsy complication rates.MATERIALS AND METHODS: In this study, we performed a retrospective analysis of 199 focal liver biopsies performed in 143 patients in the setting of oncologic research protocols (research biopsy group) over a 4-year period at a single-intervention oncology service. Practice patterns and complication rates were compared with those related to 1,522 consecutive biopsies performed in 1,154 patients in whom two cores were obtained for standard clinical management of patients (standard biopsy).RESULTS: In the research biopsy group, 1,100 tissue cores (average, 5.5 cores per procedure) were harvested and distributed to trial sponsors, internal research laboratories, and pathology services. The complication rate in this cohort was 0.5% for major complications (one of 199) and 1.0% for minor complications managed conservatively (two of 199). In the standard biopsy control group, major complications were observed in 1.4% of procedures (22 of 1,522) and minor complications in 0.2% (three of 1,522). These complication rates were not statistically different.CONCLUSION: Harvesting extra tissue cores through coaxial needles during focal liver biopsies does not increase complication rates and yields valuable tissue for additional experimental testing.