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Plasma Genotyping at the Time of Diagnostic Tissue Biopsy Decreases Time-to-Treatment in Patients With Advanced NSCLC—Results From a Prospective Pilot Study
INTRODUCTION: 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 suspecte...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8980884/ https://www.ncbi.nlm.nih.gov/pubmed/35392653 http://dx.doi.org/10.1016/j.jtocrr.2022.100301 |
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author | Thompson, Jeffrey C. Aggarwal, Charu Wong, Janeline Nimgaonkar, Vivek Hwang, Wei-Ting Andronov, Michelle Dibardino, David M. Hutchinson, Christoph T. Ma, Kevin C. Lanfranco, Anthony Moon, Edmund Haas, Andrew R. Singh, Aditi P. Ciunci, Christine A. Marmarelis, Melina D’Avella, Christopher Cohen, Justine V. Bauml, Joshua M. Cohen, Roger B. Langer, Corey J. Vachani, Anil Carpenter, Erica L. |
author_facet | Thompson, Jeffrey C. Aggarwal, Charu Wong, Janeline Nimgaonkar, Vivek Hwang, Wei-Ting Andronov, Michelle Dibardino, David M. Hutchinson, Christoph T. Ma, Kevin C. Lanfranco, Anthony Moon, Edmund Haas, Andrew R. Singh, Aditi P. Ciunci, Christine A. Marmarelis, Melina D’Avella, Christopher Cohen, Justine V. Bauml, Joshua M. Cohen, Roger B. Langer, Corey J. Vachani, Anil Carpenter, Erica L. |
author_sort | Thompson, Jeffrey C. |
collection | PubMed |
description | INTRODUCTION: 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. METHODS: 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. RESULTS: 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). CONCLUSIONS: 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. |
format | Online Article Text |
id | pubmed-8980884 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-89808842022-04-06 Plasma Genotyping at the Time of Diagnostic Tissue Biopsy Decreases Time-to-Treatment in Patients With Advanced NSCLC—Results From a Prospective Pilot Study Thompson, Jeffrey C. Aggarwal, Charu Wong, Janeline Nimgaonkar, Vivek Hwang, Wei-Ting Andronov, Michelle Dibardino, David M. Hutchinson, Christoph T. Ma, Kevin C. Lanfranco, Anthony Moon, Edmund Haas, Andrew R. Singh, Aditi P. Ciunci, Christine A. Marmarelis, Melina D’Avella, Christopher Cohen, Justine V. Bauml, Joshua M. Cohen, Roger B. Langer, Corey J. Vachani, Anil Carpenter, Erica L. JTO Clin Res Rep Brief Report INTRODUCTION: 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. METHODS: 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. RESULTS: 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). CONCLUSIONS: 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. Elsevier 2022-03-08 /pmc/articles/PMC8980884/ /pubmed/35392653 http://dx.doi.org/10.1016/j.jtocrr.2022.100301 Text en © 2022 The Authors https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Brief Report Thompson, Jeffrey C. Aggarwal, Charu Wong, Janeline Nimgaonkar, Vivek Hwang, Wei-Ting Andronov, Michelle Dibardino, David M. Hutchinson, Christoph T. Ma, Kevin C. Lanfranco, Anthony Moon, Edmund Haas, Andrew R. Singh, Aditi P. Ciunci, Christine A. Marmarelis, Melina D’Avella, Christopher Cohen, Justine V. Bauml, Joshua M. Cohen, Roger B. Langer, Corey J. Vachani, Anil Carpenter, Erica L. Plasma Genotyping at the Time of Diagnostic Tissue Biopsy Decreases Time-to-Treatment in Patients With Advanced NSCLC—Results From a Prospective Pilot Study |
title | Plasma Genotyping at the Time of Diagnostic Tissue Biopsy Decreases Time-to-Treatment in Patients With Advanced NSCLC—Results From a Prospective Pilot Study |
title_full | Plasma Genotyping at the Time of Diagnostic Tissue Biopsy Decreases Time-to-Treatment in Patients With Advanced NSCLC—Results From a Prospective Pilot Study |
title_fullStr | Plasma Genotyping at the Time of Diagnostic Tissue Biopsy Decreases Time-to-Treatment in Patients With Advanced NSCLC—Results From a Prospective Pilot Study |
title_full_unstemmed | Plasma Genotyping at the Time of Diagnostic Tissue Biopsy Decreases Time-to-Treatment in Patients With Advanced NSCLC—Results From a Prospective Pilot Study |
title_short | Plasma Genotyping at the Time of Diagnostic Tissue Biopsy Decreases Time-to-Treatment in Patients With Advanced NSCLC—Results From a Prospective Pilot Study |
title_sort | plasma genotyping at the time of diagnostic tissue biopsy decreases time-to-treatment in patients with advanced nsclc—results from a prospective pilot study |
topic | Brief Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8980884/ https://www.ncbi.nlm.nih.gov/pubmed/35392653 http://dx.doi.org/10.1016/j.jtocrr.2022.100301 |
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