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Repeat Biopsy for Mutational Analysis of Non-Small Cell Lung Cancers Resistant to Previous Chemotherapy: Adequacy and Complications.
MedLine Citation:
PMID:  22929335     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Purpose:To evaluate the feasibility and safety of repeat biopsy for mutational analysis in patients with non-small cell lung cancer (NSCLC) who have a resistance history to previous chemotherapy.Materials and Methods:This prospective study was institutional review board approved, and written informed consent was obtained from all patients. Of 126 patients referred for repeat biopsy (hereafter, rebiopsy) with NSCLC that was resistant to conventional chemotherapy or epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors, 94 patients (31 men, 63 women; mean age ± standard deviation, 57 years ± 10.3) were selected for rebiopsy. Thirty-two patients were excluded for several reasons after strict review of the chest computed tomography (CT) images. Percutaneous transthoracic lung biopsy was performed with C-arm cone-beam CT guidance. The technical success rates for the rebiopsy and the adequacy rates of specimens for mutational analysis were evaluated. Any biopsy-related complications were recorded.Results:The technical success rate for biopsy was 100%. In 75 (80%) of 94 patients, specimens were adequate for mutational analysis. Of 75 specimens, 35 were tested for EGFR mutation, 34 for anaplastic lymphoma kinase gene (ALK) rearrangement, and six for both. The results were positive for EGFR-sensitizing mutation (exon 19 or 21) in 20, for EGFR T790M mutation in five, and for ALK rearrangement in 11. Postprocedural complications occurred in 13 (14%) of 94 patients.Conclusion:When performed by employing rigorous CT criteria, rebiopsies for the mutational analysis of NSCLCs treated previously with chemotherapy are feasible in all patients and are adequate in approximately four-fifths of patients referred for gene analysis, with acceptable rates of complications.© RSNA, 2012.
Authors:
Hyun Jung Yoon; Ho Yun Lee; Kyung Soo Lee; Yoon-La Choi; Myung-Ju Ahn; Keunchil Park; Jin Seok Ahn; Jong-Mu Sun; Jhingook Kim; Tae Sung Kim; Myung Jin Chung; Chin A Yi
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-8-28
Journal Detail:
Title:  Radiology     Volume:  -     ISSN:  1527-1315     ISO Abbreviation:  Radiology     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-8-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Radiology and Center for Imaging Science, Department of Pathology, Division of Hematology-Oncology, Department of Medicine, and Department of Thoracic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-Dong, Kangnam-Ku, Seoul 135-710, Korea.
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