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Gene Expression Profiling of Non-small Cell Lung Cancer With Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration
Lung Cancer SESSION TITLE: Lung Cancer I SESSION TYPE: Original Investigation Poster PRESENTED ON: Wednesday, October 26, 2016 at 01:30 PM - 02:30 PM
Gene Expression Profiling of Non-small Cell Lung Cancer With Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration Christina Bellinger MD* Travis Dotson MD Deepankar Sharma MD William Petty MD; and Edward Haponik MD Wake Forest Baptist Health, Winston Salem, NC PURPOSE: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive modality to diagnose and stage nonsmall cell lung cancer. Advances in lung cancer have revealed mutations that are susceptible to targeted therapeutic agents and guidelines recommend testing for mutations. Limited information exists as to the ability of EBUS-TBNA to obtain adequate sample for next generation sequencing of nonsmall cell lung cancer. As a quality improvement initiative and feasibility study, we assessed whether EBUS-TBNA can provide sufficient material for next generation sequencing. METHODS: Patients were identified this initiative if on-site cytology determined a high suspicion of nonsmall cell lung cancer. Five dedicated EBUS-TBNA were isolated for submission. Samples deemed sufficient by our Pathologists were sent for comprehensive genomic profile using a hybrid capture-based next generation sequencing platform (FoundationOne) at a Clinical Laboratory Improvement Amendments (CLIA) certified site. RESULTS: To date, ten patients have had material isolated for next generation sequencing. Three have been determined to have sufficient material and one is insufficient (all adenocarcinomas). Six patients have pending samples (these are 2 squamous, 1 adenosquamous, 2 adenocarcinoma and 1 not otherwise specified). All three patients with completed studies were found to have Kras mutations, and one was found to have a CDK4 mutation. These two mutations have FDA approved therapies. Additional reported mutations include RAD50, ALL2, RUNX1T1, TP53, U2AF1, Notch3. There were no procedural complications.
LUNG CANCER
CONCLUSIONS: These initial observations demonstrate that EBUS-TBNA can achieve sufficient material for next generation sequencing. Follow-up and further data will help evaluate the overall rate of sufficiency for EBUS-TBNA in providing adequate material for advanced genetic testing in nonsmall cell lung cancer as well as factors that may affect yield including location, size and pet avidity. CLINICAL IMPLICATIONS: In the era of precision medicine, EBUS-TBNA continues to prove its worth in providing adequate material for diagnosing, subtyping and gene profiling nonsmall cell lung cancer. DISCLOSURE: The following authors have nothing to disclose: Christina Bellinger, Travis Dotson, Deepankar Sharma, William Petty, Edward Haponik No Product/Research Disclosure Information DOI:
http://dx.doi.org/10.1016/j.chest.2016.08.797
Copyright ª 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.
702A
[
150#4S CHEST OCTOBER 2016
]
Gene Expression Profiling of Non-small Cell Lung Cancer With Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration Christina Bellinger MD* Travis Dotson MD Deepankar Sharma MD William Petty MD; and Edward Haponik MD Wake Forest Baptist Health, Winston Salem, NC PURPOSE: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive modality to diagnose and stage nonsmall cell lung cancer. Advances in lung cancer have revealed mutations that are susceptible to targeted therapeutic agents and guidelines recommend testing for mutations. Limited information exists as to the ability of EBUS-TBNA to obtain adequate sample for next generation sequencing of nonsmall cell lung cancer. As a quality improvement initiative and feasibility study, we assessed whether EBUS-TBNA can provide sufficient material for next generation sequencing. METHODS: Patients were identified this initiative if on-site cytology determined a high suspicion of nonsmall cell lung cancer. Five dedicated EBUS-TBNA were isolated for submission. Samples deemed sufficient by our Pathologists were sent for comprehensive genomic profile using a hybrid capture-based next generation sequencing platform (FoundationOne) at a Clinical Laboratory Improvement Amendments (CLIA) certified site. RESULTS: To date, ten patients have had material isolated for next generation sequencing. Three have been determined to have sufficient material and one is insufficient (all adenocarcinomas). Six patients have pending samples (these are 2 squamous, 1 adenosquamous, 2 adenocarcinoma and 1 not otherwise specified). All three patients with completed studies were found to have Kras mutations, and one was found to have a CDK4 mutation. These two mutations have FDA approved therapies. Additional reported mutations include RAD50, ALL2, RUNX1T1, TP53, U2AF1, Notch3. There were no procedural complications.
LUNG CANCER
CONCLUSIONS: These initial observations demonstrate that EBUS-TBNA can achieve sufficient material for next generation sequencing. Follow-up and further data will help evaluate the overall rate of sufficiency for EBUS-TBNA in providing adequate material for advanced genetic testing in nonsmall cell lung cancer as well as factors that may affect yield including location, size and pet avidity. CLINICAL IMPLICATIONS: In the era of precision medicine, EBUS-TBNA continues to prove its worth in providing adequate material for diagnosing, subtyping and gene profiling nonsmall cell lung cancer. DISCLOSURE: The following authors have nothing to disclose: Christina Bellinger, Travis Dotson, Deepankar Sharma, William Petty, Edward Haponik No Product/Research Disclosure Information DOI:
http://dx.doi.org/10.1016/j.chest.2016.08.797
Copyright ª 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.
702A
[
150#4S CHEST OCTOBER 2016
]