Improving the turnaround time of molecular profiling for advanced non-small cell lung cancer: Outcome of a new algorithm integrating multiple approaches.

Diagnostic Genomic profiling Non-small cell lung cancer Personalized treatment

Journal

Pathology, research and practice
ISSN: 1618-0631
Titre abrégé: Pathol Res Pract
Pays: Germany
ID NLM: 7806109

Informations de publication

Date de publication:
Aug 2023
Historique:
received: 06 04 2023
revised: 29 06 2023
accepted: 30 06 2023
pubmed: 7 7 2023
medline: 7 7 2023
entrez: 6 7 2023
Statut: ppublish

Résumé

Molecular tumor profiling to identify oncogenic drivers and actionable mutations has a profound impact on how lung cancer is treated. Especially in the subgroup of non-small cell lung cancer (NSCLC), molecular testing for certain mutations is crucial in daily clinical practice and is recommended by international guidelines. To date, a standardized approach to identify druggable genetic alterations are lacking. We have developed and implemented a new diagnostic algorithm to harmonize the molecular testing of NSCLC. In this retrospective analysis, we reviewed 119 patients diagnosed with NSCLC at the University Hospital Zurich. Tumor samples were analyzed using our standardized diagnostic algorithm: After the histological diagnosis was made, tissue samples were further analyzed by immunohistochemical stainings as well as the real-time PCR test Idylla™. Extracted DNA was further utilized for comprehensive genomic profiling (FoundationOne®CDx, F1CDx). Out of the 119 patients were included in this study, 100 patients were diagnosed with non-squamous NSCLC (nsqNSCLC) and 19 with squamous NSCLC (sqNSCLC). The samples from the nsqNSCLC patients underwent testing by Idylla™ and were evaluated by immunohistochemistry (IHC). F1CDx analysis was run on 67 samples and 46 potentially actionable genomic alterations were detected. Ten patients received the indicated targeted treatment. The median time to test results was 4 days for the Idylla test, 5 days for IHC and 13 days for the F1CDx. In patients with NSCLC, the implementation of a standardized molecular testing algorithm provided information on predictive markers for NSCLC within a few working days. The implementation of broader genomic profiling led to the identification of actionable targets, which would otherwise not have been discovered.

Sections du résumé

BACKGROUND BACKGROUND
Molecular tumor profiling to identify oncogenic drivers and actionable mutations has a profound impact on how lung cancer is treated. Especially in the subgroup of non-small cell lung cancer (NSCLC), molecular testing for certain mutations is crucial in daily clinical practice and is recommended by international guidelines. To date, a standardized approach to identify druggable genetic alterations are lacking. We have developed and implemented a new diagnostic algorithm to harmonize the molecular testing of NSCLC.
PATIENTS AND METHODS METHODS
In this retrospective analysis, we reviewed 119 patients diagnosed with NSCLC at the University Hospital Zurich. Tumor samples were analyzed using our standardized diagnostic algorithm: After the histological diagnosis was made, tissue samples were further analyzed by immunohistochemical stainings as well as the real-time PCR test Idylla™. Extracted DNA was further utilized for comprehensive genomic profiling (FoundationOne®CDx, F1CDx).
RESULTS RESULTS
Out of the 119 patients were included in this study, 100 patients were diagnosed with non-squamous NSCLC (nsqNSCLC) and 19 with squamous NSCLC (sqNSCLC). The samples from the nsqNSCLC patients underwent testing by Idylla™ and were evaluated by immunohistochemistry (IHC). F1CDx analysis was run on 67 samples and 46 potentially actionable genomic alterations were detected. Ten patients received the indicated targeted treatment. The median time to test results was 4 days for the Idylla test, 5 days for IHC and 13 days for the F1CDx.
CONCLUSION CONCLUSIONS
In patients with NSCLC, the implementation of a standardized molecular testing algorithm provided information on predictive markers for NSCLC within a few working days. The implementation of broader genomic profiling led to the identification of actionable targets, which would otherwise not have been discovered.

Identifiants

DOI: 10.1016/j.prp.2023.154660 PMID: 37413876
pubmed: 37413876
pii: S0344-0338(23)00360-6
doi: 10.1016/j.prp.2023.154660
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

154660

Informations de copyright

Copyright © 2023 The Authors. Published by Elsevier GmbH.. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest No conflict of interest.

Auteurs

G Treichler (G)

Department of Medical Oncology and Hematology University Hospital Zurich, Switzerland; Comprehensive Cancer Center Zurich, Switzerland; Department of Medical Oncology and Hematology, Cantonal Hospital Winterthur, Switzerland.

S Hoeller (S)

Department of Medical Oncology and Hematology University Hospital Zurich, Switzerland; Department of Pathology and Molecular Pathology, University Hospital Zurich, 8091 Zurich, Switzerland; University of Zurich, Switzerland; Comprehensive Cancer Center Zurich, Switzerland.

J H Rueschoff (JH)

Department of Pathology and Molecular Pathology, University Hospital Zurich, 8091 Zurich, Switzerland.

M Rechsteiner (M)

Department of Pathology and Molecular Pathology, University Hospital Zurich, 8091 Zurich, Switzerland.

C Britschgi (C)

Department of Medical Oncology and Hematology University Hospital Zurich, Switzerland; University of Zurich, Switzerland; Comprehensive Cancer Center Zurich, Switzerland.

F Arnold (F)

Department of Pathology and Molecular Pathology, University Hospital Zurich, 8091 Zurich, Switzerland.

M Zoche (M)

Department of Pathology and Molecular Pathology, University Hospital Zurich, 8091 Zurich, Switzerland.

S Hiltbrunner (S)

Department of Medical Oncology and Hematology University Hospital Zurich, Switzerland; Comprehensive Cancer Center Zurich, Switzerland; Faculty of Science and Medicine, University of Fribourg, Switzerland.

H Moch (H)

Department of Pathology and Molecular Pathology, University Hospital Zurich, 8091 Zurich, Switzerland.

D Akhoundova (D)

Department of Medical Oncology and Hematology University Hospital Zurich, Switzerland; Comprehensive Cancer Center Zurich, Switzerland; Department of Oncology, University Hospital Bern, Switzerland.

I Opitz (I)

University of Zurich, Switzerland; Department of Thoracic Surgery, University Hospital Zurich, Switzerland.

A Curioni-Fontecedro (A)

Department of Medical Oncology and Hematology University Hospital Zurich, Switzerland; University of Zurich, Switzerland; Comprehensive Cancer Center Zurich, Switzerland; Faculty of Science and Medicine, University of Fribourg, Switzerland; Department of Oncology, Cantonal Hospital Fribourg, Switzerland. Electronic address: alessandra.curioni-fontecedro@h-fr.ch.

Classifications MeSH