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Diagnostic Accuracy and Safety of Coaxial System in Oncology Patients Treated in a Specialist Cancer Center With Prospective Validation Within Clinical Trial Data
BACKGROUND: Image-guided tissue biopsies are critically important in the diagnosis and management of cancer patients. High-yield samples are also vital for biomarker and resistance mechanism discovery through molecular/genomic analyses. PATIENTS AND METHODS: All consecutive patients who underwent pl...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7500492/ https://www.ncbi.nlm.nih.gov/pubmed/33014822 http://dx.doi.org/10.3389/fonc.2020.01634 |
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author | Khan, Khurum Gonzalez-Exposito, Reyes Cunningham, David Koh, Dow-Mu Woolston, Andrew Barber, Louise Griffiths, Beatrice Kouvelakis, Kyriakos Calamai, Vanessa Bali, Monia Khan, Nasir Bryant, Annette Saffery, Claire Dearman, Charles Begum, Ruwaida Rao, Sheela Starling, Naureen Watkins, David Chau, Ian Braconi, Chiara Valeri, Nicola Gerlinger, Marco Fotiadis, Nicos |
author_facet | Khan, Khurum Gonzalez-Exposito, Reyes Cunningham, David Koh, Dow-Mu Woolston, Andrew Barber, Louise Griffiths, Beatrice Kouvelakis, Kyriakos Calamai, Vanessa Bali, Monia Khan, Nasir Bryant, Annette Saffery, Claire Dearman, Charles Begum, Ruwaida Rao, Sheela Starling, Naureen Watkins, David Chau, Ian Braconi, Chiara Valeri, Nicola Gerlinger, Marco Fotiadis, Nicos |
author_sort | Khan, Khurum |
collection | PubMed |
description | BACKGROUND: Image-guided tissue biopsies are critically important in the diagnosis and management of cancer patients. High-yield samples are also vital for biomarker and resistance mechanism discovery through molecular/genomic analyses. PATIENTS AND METHODS: All consecutive patients who underwent plugged image-guided biopsy at Royal Marsden from June 2013 until September 2016 were included in the analysis. In the next step, a second cohort of patients prospectively treated within two clinical trials (PROSPECT-C and PROSPECT-R) were assessed for the DNA yield from biopsies assessed for complex genomic analysis. RESULTS: A total of 522 plugged core biopsies were performed in 457 patients [men, 52%; median age, 63 years (range, 17–93)]. Histological diagnosis was achieved in 501 of 522 (96%) performed biopsies. Age, gender, modality, metastatic site, and seniority of the interventionist were not found to be significant factors associated with odds of failure on a logistic regression. Seventeen (3.3%) were admitted due to biopsy-related complications; nine, three, two, one, one, and one were admitted for grade I/II pain control, sepsis, vasovagal syncope, thrombosis, hematuria, and deranged liver functions, respectively; two patients with right upper quadrant pain after liver biopsy were found to have radiologically confirmed subcapsular hematoma requiring conservative treatment. One patient (0.2%) developed grade III hemorrhage following biopsy of a gastric gastrointestinal stromal tumor (GIST). Overall molecular analysis was successful in 89% (197/222 biopsies). Prospective validation in 62 biopsies gave success rates of 92.06 and 79.03% for DNA extraction of >1 μm and tmour content of >20%, respectively. CONCLUSION: The probability of diagnostic success for complex molecular analysis is increased with plugged large coaxial needle biopsy technique, which also minimizes complications and reduces hospital stay. High-yield DNA acquisition allows genomic molecular characterization for personalized medicine. |
format | Online Article Text |
id | pubmed-7500492 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-75004922020-10-02 Diagnostic Accuracy and Safety of Coaxial System in Oncology Patients Treated in a Specialist Cancer Center With Prospective Validation Within Clinical Trial Data Khan, Khurum Gonzalez-Exposito, Reyes Cunningham, David Koh, Dow-Mu Woolston, Andrew Barber, Louise Griffiths, Beatrice Kouvelakis, Kyriakos Calamai, Vanessa Bali, Monia Khan, Nasir Bryant, Annette Saffery, Claire Dearman, Charles Begum, Ruwaida Rao, Sheela Starling, Naureen Watkins, David Chau, Ian Braconi, Chiara Valeri, Nicola Gerlinger, Marco Fotiadis, Nicos Front Oncol Oncology BACKGROUND: Image-guided tissue biopsies are critically important in the diagnosis and management of cancer patients. High-yield samples are also vital for biomarker and resistance mechanism discovery through molecular/genomic analyses. PATIENTS AND METHODS: All consecutive patients who underwent plugged image-guided biopsy at Royal Marsden from June 2013 until September 2016 were included in the analysis. In the next step, a second cohort of patients prospectively treated within two clinical trials (PROSPECT-C and PROSPECT-R) were assessed for the DNA yield from biopsies assessed for complex genomic analysis. RESULTS: A total of 522 plugged core biopsies were performed in 457 patients [men, 52%; median age, 63 years (range, 17–93)]. Histological diagnosis was achieved in 501 of 522 (96%) performed biopsies. Age, gender, modality, metastatic site, and seniority of the interventionist were not found to be significant factors associated with odds of failure on a logistic regression. Seventeen (3.3%) were admitted due to biopsy-related complications; nine, three, two, one, one, and one were admitted for grade I/II pain control, sepsis, vasovagal syncope, thrombosis, hematuria, and deranged liver functions, respectively; two patients with right upper quadrant pain after liver biopsy were found to have radiologically confirmed subcapsular hematoma requiring conservative treatment. One patient (0.2%) developed grade III hemorrhage following biopsy of a gastric gastrointestinal stromal tumor (GIST). Overall molecular analysis was successful in 89% (197/222 biopsies). Prospective validation in 62 biopsies gave success rates of 92.06 and 79.03% for DNA extraction of >1 μm and tmour content of >20%, respectively. CONCLUSION: The probability of diagnostic success for complex molecular analysis is increased with plugged large coaxial needle biopsy technique, which also minimizes complications and reduces hospital stay. High-yield DNA acquisition allows genomic molecular characterization for personalized medicine. Frontiers Media S.A. 2020-09-04 /pmc/articles/PMC7500492/ /pubmed/33014822 http://dx.doi.org/10.3389/fonc.2020.01634 Text en Copyright © 2020 Khan, Gonzalez-Exposito, Cunningham, Koh, Woolston, Barber, Griffiths, Kouvelakis, Calamai, Bali, Khan, Bryant, Saffery, Dearman, Begum, Rao, Starling, Watkins, Chau, Braconi, Valeri, Gerlinger and Fotiadis. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Oncology Khan, Khurum Gonzalez-Exposito, Reyes Cunningham, David Koh, Dow-Mu Woolston, Andrew Barber, Louise Griffiths, Beatrice Kouvelakis, Kyriakos Calamai, Vanessa Bali, Monia Khan, Nasir Bryant, Annette Saffery, Claire Dearman, Charles Begum, Ruwaida Rao, Sheela Starling, Naureen Watkins, David Chau, Ian Braconi, Chiara Valeri, Nicola Gerlinger, Marco Fotiadis, Nicos Diagnostic Accuracy and Safety of Coaxial System in Oncology Patients Treated in a Specialist Cancer Center With Prospective Validation Within Clinical Trial Data |
title | Diagnostic Accuracy and Safety of Coaxial System in Oncology Patients Treated in a Specialist Cancer Center With Prospective Validation Within Clinical Trial Data |
title_full | Diagnostic Accuracy and Safety of Coaxial System in Oncology Patients Treated in a Specialist Cancer Center With Prospective Validation Within Clinical Trial Data |
title_fullStr | Diagnostic Accuracy and Safety of Coaxial System in Oncology Patients Treated in a Specialist Cancer Center With Prospective Validation Within Clinical Trial Data |
title_full_unstemmed | Diagnostic Accuracy and Safety of Coaxial System in Oncology Patients Treated in a Specialist Cancer Center With Prospective Validation Within Clinical Trial Data |
title_short | Diagnostic Accuracy and Safety of Coaxial System in Oncology Patients Treated in a Specialist Cancer Center With Prospective Validation Within Clinical Trial Data |
title_sort | diagnostic accuracy and safety of coaxial system in oncology patients treated in a specialist cancer center with prospective validation within clinical trial data |
topic | Oncology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7500492/ https://www.ncbi.nlm.nih.gov/pubmed/33014822 http://dx.doi.org/10.3389/fonc.2020.01634 |
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