Plasma Genotyping at the Time of Diagnostic Tissue Biopsy Decreases Time-to-Treatment in Patients With Advanced NSCLC-Results From a Prospective Pilot Study.
Plasma Genotyping at the Time of Diagnostic Tissue Biopsy Decreases Time-to-Treatment in Patients With Advanced NSCLC-Results From a Prospective Pilot Study.
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DOI：
10.1016/j.jtocrr.2022.100301
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发表时间：
2022-04
影响因子：
--
通讯作者：
Carpenter EL
中科院分区：
文献类型：
--
作者：
Thompson JC;Aggarwal C;Wong J;Nimgaonkar V;Hwang WT;Andronov M;Dibardino DM;Hutchinson CT;Ma KC;Lanfranco A;Moon E;Haas AR;Singh AP;Ciunci CA;Marmarelis M;D'Avella C;Cohen JV;Bauml JM;Cohen RB;Langer CJ;Vachani A;Carpenter EL
靶向治疗的可用性已经改变了晚期NSCLC的管理；然而，大多数患者不接受指南推荐的肿瘤基因分型。基于血浆的下一代测序（NGS）与诊断活检同时进行对疑似晚期NSCLC的影响在很大程度上尚未探索。我们基于横断面成像结果对疑似晚期肺癌患者进行了一项前瞻性队列研究。使用市售的74个基因面板对活检时的血液进行测序。主要结局指标是一线全身治疗的时间，与连续的伴有反射性组织NGS的晚期NSCLC患者的回顾性队列进行比较。我们分析了110例新诊断的晚期NSCLC患者的NGS结果：队列1和2各包括55例患者，并且在基线人口统计学方面平衡良好。在队列1中，血浆NGS鉴定出32例（58%）患者具有治疗信息的驱动突变（13例KRAS[5例KRAS G12C]， 13例EGFR， 2例ERRB2, 2例MET， 1例BRAF， 1例RET）。队列1中85%的患者在第一次肿瘤就诊前获得了NGS结果，而队列2中只有9% (p < 0.0001)，更多的队列1患者在这次就诊时接受了与指南一致的治疗建议（74%对46%，p = 0.005）。与队列2相比，队列1的治疗时间显著缩短（12天和20天，p = 0.003），具有特定驱动突变的患者的治疗时间更短（10天和19天，p = 0.001）。疑似晚期NSCLC患者在诊断活检时进行基于血浆的NGS与常规护理相比，缩短了治疗时间。
The availability of targeted therapies has transformed the management of advanced NSCLC; however, most patients do not undergo guideline-recommended tumor genotyping. The impact of plasma-based next-generation sequencing (NGS) performed simultaneously with diagnostic biopsy in suspected advanced NSCLC has largely been unexplored. We performed a prospective cohort study of patients with suspected advanced lung cancer on the basis of cross-sectional imaging results. Blood from the time of biopsy was sequenced using a commercially available 74-gene panel. The primary outcome measure was time to first-line systemic treatment compared with a retrospective cohort of consecutive patients with advanced NSCLC with reflex tissue NGS. We analyzed the NGS results from 110 patients with newly diagnosed advanced NSCLC: cohorts 1 and 2 included 55 patients each and were well balanced regarding baseline demographics. In cohort 1, plasma NGS identified therapeutically informative driver mutations in 32 patients (58%) (13 KRAS [five KRAS G12C], 13 EGFR, two ERRB2, two MET, one BRAF, one RET). The NGS results were available before the first oncology visit in 85% of cohort 1 versus 9% in cohort 2 (p < 0.0001), with more cohort 1 patients receiving a guideline-concordant treatment recommendation at this visit (74% versus 46%, p = 0.005). Time-to-treatment was significantly shorter in cohort 1 compared with cohort 2 (12 versus 20 d, p = 0.003), with a shorter time-to-treatment in patients with specific driver mutations (10 versus 19 d, p = 0.001). Plasma-based NGS performed at the time of diagnostic biopsy in patients with suspected advanced NSCLC is associated with decreased time-to-treatment compared with usual care.
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影响因子：
4.6
作者：
Thompson, Jeffrey C.;Carpenter, Erica L.;Aggarwal, Charu
通讯作者：
Aggarwal, Charu
影响因子：
50.5
作者：
Lim, C.;Tsao, M. S.;Leighl, N. B.
通讯作者：
Leighl, N. B.
影响因子：
28.4
作者：
Aggarwal, Charu;Thompson, Jeffrey C.;Carpenter, Erica L.
通讯作者：
Carpenter, Erica L.
DOI：
10.1097/jto.0000000000000516
发表时间：
2015-05
期刊：
Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer
影响因子：
--
作者：
Sholl LM;Aisner DL;Varella-Garcia M;Berry LD;Dias-Santagata D;Wistuba II;Chen H;Fujimoto J;Kugler K;Franklin WA;Iafrate AJ;Ladanyi M;Kris MG;Johnson BE;Bunn PA;Minna JD;Kwiatkowski DJ;LCMC Investigators
通讯作者：
LCMC Investigators
影响因子：
6.2
作者：
Mack, Philip C.;Banks, Kimberly C.;Gandara, David R.
通讯作者：
Gandara, David R.