Developments in predictive biomarker testing and targeted therapy in advanced stage non-small cell lung cancer and their application across European countries

The Lancet Regional Health - Europe, Journal Year: 2024, Volume and Issue: 38, P. 100838 - 100838

Published: March 1, 2024

In the past two decades, treatment of metastatic non-small cell lung cancer (NSCLC), has undergone significant changes due to introduction targeted therapies and immunotherapy. These advancements have led need for predictive molecular tests identify patients eligible therapy. This review provides an overview development current application biomarker testing in European with advanced stage NSCLC. Using data from eleven countries, we conclude that recommendations are incorporated national guidelines across Europe, although there differences their comprehensiveness. Moreover, availability recently EMA-approved varies between countries. Unfortunately, routine assessment national/regional rates is limited. As a result, it remains uncertain which proportion NSCLC Europe receive adequate testing. Lastly, Molecular Tumor Boards (MTBs) discussion test results widely implemented, but composition functioning lacking. The establishment MTB can provide framework interpreting rare or complex mutations, facilitating appropriate decision-making, ensuring quality control.

Language: Английский

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HER2 evaluation for clinical decision making in human solid tumours: pearls and pitfalls

Histopathology, Journal Year: 2024, Volume and Issue: 85(1), P. 3 - 19

Published: March 5, 2024

The significant clinical benefits of human epidermal growth factor receptor 2 (HER2)‐targeted therapeutic agents have revolutionized the treatment landscape in a variety solid tumours. Accordingly, accurate evaluation HER2 status these different tumour types is critical for decision making to select appropriate patients who may benefit from life‐saving HER2‐targeted therapies. biomarker scoring criteria organ systems, and close adherence corresponding testing guidelines their updates, if available, essential evaluation. In addition, knowing unusual patterns expression also important avoid inaccurate this review, we discuss key considerations when evaluating tumours making, including tissue handling preparation testing, as well pathologist's readout results breast carcinomas, gastroesophageal adenocarcinomas, colorectal gynaecologic non‐small cell lung carcinomas.

Language: Английский

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Impact of Molecular Testing Using Next-Generation Sequencing in the Clinical Management of Patients with Non-Small Cell Lung Cancer in a Public Healthcare Hospital

Cancers, Journal Year: 2023, Volume and Issue: 15(6), P. 1705 - 1705

Published: March 10, 2023

Next-generation sequencing (NGS) is a molecular approach able to provide comprehensive profile of non-small cell lung cancer (NSCLC). The broad spectrum biomarker-guided therapies has positioned diagnostic laboratories as central component patient clinical management. Here, we show the results an UNE-EN ISO 15189:2022 NGS-accredited assay in cohort 350 patients. TP53 (51.0%), KRAS (26.6%) and EGFR (12.9%) were most frequently mutated genes. Furthermore, detected co-occurring mutually exclusive alterations, well distinct profiles according sex smoking habits. Actionable genetic alterations significantly more frequent female patients (80.5%, p < 0.001) never-smoker (87.7%, 0.001). When NGS was established main testing strategy, 36.4% received at least one line targeted treatment. Among 200 with stage IV NSCLC, first-line treatment associated longer progression-free survival (PFS) (13.4 months (95% CI, 10.2-16.6) (p = 0.001)). Similarly, overall (OS) receiving drug (26.2 11.8-40.5) Our that implementation public healthcare system provided broader application precision medicine.

Language: Английский

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EBUS-TBNA and CryoEBUS of the mediastinal lymph node. One hundred seventy-eight cases. Validation of the WHO Reporting System for Lymph Node Cytopathology. Proposed CryoEBUS diagnostic flow chart and indications. The view of the interventional pathologist

Revista Española de Patología, Journal Year: 2025, Volume and Issue: 58(1), P. 100799 - 100799

Published: Jan. 1, 2025

Microscopic assessment is essential in the study of mediastinal lymph nodes. Obtaining cytological samples through Endobronchial Ultrasound TransBronchial Needle Aspiration (EBUS-TBNA) has long been considered gold standard procedure. The implementation World Health Organization (WHO) Reporting System for Lymph Node Cytopathology, along with advancement CryoEBUS node technique, enhanced and refined diagnostic accuracy this field. During a two-year period, cases involving parallel performance EBUS-TBNA specimen collection were quantified. WHO allowed comparison yield between tissue samples. A total 178 procedures conducted, mean patient age 63 years male predominance 72.5%. station 7 was most sampled site, accounting 38.76% cases. Category V - malignant common diagnosis, representing 50% cases, while 46.62% malignant. Pearson correlation coefficient two methods calculated at 0.99. combined Cytopathology simultaneous use resulted accuracy, reducing non-diagnostic to less than 3%.

Language: Английский

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Brief Report: Real-World Clinical Utility of Next-Generation Sequencing of Circulating Tumor DNA for Patients with Advanced Lung Squamous Cell Carcinoma (SQUIN)

Clinical Lung Cancer, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 1, 2025

Language: Английский

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Clinical Impact of a Next-Generation Sequencing Approach for Glioblastoma Patients

Cancers, Journal Year: 2025, Volume and Issue: 17(5), P. 744 - 744

Published: Feb. 22, 2025

Objectives: The purpose of this study is to assess the clinical impact next-generation sequencing (NGS), as an increasingly available and advantageous tool, for glioblastoma patients. Methods: Adult patients aged less than 65, surgically treated between 2010-2021, were included. Tumor samples analyzed with NGS using Oncomine Comprehensive v3 (OCA) panel Ion Reporter Genexus v5.9.1 (Thermo Fisher Scientific). Results: Thirty-two included, a median age 47.7 years overall survival 25 months. Identification mutations by resulted in change diagnosis two cases. In all but one, at least one genetic alteration was detected (median three per patient), most commonly EGFR amplification. 93.7% patients, biomarkers that make them potentially eligible trial found. No differences seen regarding alterations, although trend towards better those without CDK4 mutation observed (p = 0.088). Conclusions: use provides useful information diagnosis, especially young it will probably become valuable decision-making more therapeutic targets treatments emerge. For moment, crucial scientific progress happen.

Language: Английский

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Carcinoma de pulmón de célula no pequeña

Medicine - Programa de Formación Médica Continuada Acreditado, Journal Year: 2025, Volume and Issue: 14(27), P. 1580 - 1594

Published: March 1, 2025

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Biomarcadores predictivos en el cáncer de pulmón. Implicaciones terapéuticas

Medicine - Programa de Formación Médica Continuada Acreditado, Journal Year: 2025, Volume and Issue: 14(27), P. 1610 - 1613

Published: March 1, 2025

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External quality assessment for EGFR exon 20 mutation testing in patients with non-small cell lung cancer in Spain

Revista Española de Patología, Journal Year: 2025, Volume and Issue: 58(3), P. 100824 - 100824

Published: April 17, 2025

Non-small cell lung cancer (NSCLC) can arise from insertions in exon 20 of the EGFR gene, among other alterations. We carried out an external quality assessment (EQA) to evaluate accuracy laboratory methods and highlight importance detecting identifying genetic alterations, such as insertion, patients with NSCLC. The 2021 EGRF EQA program consisted two rounds, which four formalin-fixed paraffin-embedded specimens (round 1: positive for insertions/duplications, one a common alteration, wild-type; round 2: three insertions/duplications wild-type) obtained NSCLC were tested. Approximately 80% invited laboratories participated each round. most DNA isolation techniques used cobas® Sample Preparation Kit (46.7%) 1 QIAamp (37.1%) 2. frequently genotyping method both rounds was Mutation Test 53.3%; 37.1%). In 71.1% 73.6% tests, respectively, reported expected result. lowest success rate observed H773delinsRY Exon determination 17.8%; 31.4%). This alteration correctly determined only by next-generation sequencing. variability our study Spain ensure high performance.

Language: Английский

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High-Quality Samples for Next-Generation Sequencing and PD-L1 Assessment in Non-Small Cell Lung Cancer: The Role of Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration

Diagnostics, Journal Year: 2025, Volume and Issue: 15(9), P. 1064 - 1064

Published: April 22, 2025

Background/Objectives: Recent advances in the treatment of non-small cell lung cancer (NSCLC) have shifted from conventional chemotherapy to targeted therapies aimed at specific genetic mutations, particularly adenocarcinoma subtype. These improved overall survival and quality life. However, some patients still face barriers accessing these treatments due challenges diagnosing advanced-stage NSCLC. Limited tumor cellularity small biopsies cytological samples hinders ability perform further molecular analyses. Additionally, increasing number alterations requiring testing complicates diagnostic process. To overcome this challenge, we propose combining endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) with next-generation sequencing (NGS) immunohistochemistry for PD-L1. Methods: A total 120 EBUS-TBNA were consecutively collected during first year integrating NGS a reference hospital Castilla y León, Spain. Depending on histology patient characteristics, 67 analyses 116 PD-L1 determinations performed. Results: The sample obtained cases successfully achieved triple objective proposed by NCCN (diagnosis, staging, analysis single procedure) 97% instances. Conclusions: Our study highlights effectiveness as comprehensive, cost-effective, safe tool NSCLC, achieving diagnosis, cases. procedure consistently provided high-quality testing, minimal complications, reinforcing its value reliable approach optimizing personalized strategies.

Language: Английский

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