Author of

• 16751

  +

  P1.05 - Poster Session with Presenters Present (ID 457)

  • Event: WCLC 2016
  • Type: Poster Presenters Present
  • Track: Early Stage NSCLC
  • Presentations: 1
  • Moderators:
  • Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)

  • 16821

    +

    P1.05-070 - Diagnostic Yield and Efficacy of EBUS TBNA in Molecular Testing for NSCLC Mutations (ID 4401)

    14:30 - 14:30  |  Author(s): H. Oueini
    • Abstract

    Background:
    Non-small cell lung cancer (NSCLC) can be further defined at the molecular level by recurrent driver mutations including ALK, BRAF, EGFR, HER2, KRAS, MEK1, MET, NRAS, PIK3CA, RET, and ROS1. Genetic testing has become a routine part of diagnosis and staging for patients with NSCLC. The presence of mutations can influence response to targeted therapy; tailoring therapy accordingly has become standard practice.
    
    Methods:
    Sixty-nine patients referred to Indiana University Hospital with suspected or confirmed lung adenocarcinoma underwent EBUS-TBNA of lung masses or lymph nodes using a 21-gauge Olympus[TM] needle without suction. Samples were first reviewed by a pathologist, and if suspicious for NSCLC, were sent for different types of molecular testing based on the clinical scenario. At least 6 extra passes were placed in cell block. For Paradigm testing, 10 passes were sent. EGFR and KRAS testing were performed using the FDA approved Thera screen RGQ PCR Kit. Testing for ALK rearrangement was done using fluorescent in situ hybridization. In some cases, testing for these mutations in addition to ROS1, BRAF, and HER2 was done using the Paradigm Cancer Diagnostics test.
    
    Results:
    Sixty-nine samples from patients with NSCLC obtained by EBUS-TBNA were sent for molecular testing for EGFR. All samples were sufficient for analysis (Yield=100%). EGFR mutations were found in 3 patients (4.3%) vs. 66 wild-type (95.7%). 60 samples were sent for molecular testing for KRAS (yield = 100%), of which 10 had mutations (16.7%) vs. 50 wild-type (83.3%). 51 samples were sent for ROS1 testing (0 mutant, 48 wild-type); tissue samples were inadequate for testing in 3 patients (yield=94.1%). 64 samples were sent for ALK testing (3 (4.7%) mutant, 55 (85.9%) wild-type; yield = 90.6%). Ten samples were sent for BRAF testing and two samples were sent for HER2 testing, all of which were negative for mutations (yield = 100%). No complications were associated with EBUS TBNA.
    
    Conclusion:
    EBUS TBNA with a 21-gauge needle is a safe and efficient method for molecular mutational analysis in patients with NSCLC. It can be used effectively for diagnosis, staging and guiding treatment decisions for NCSLC. Adequate samples for mutational analysis can be obtained and placed in cell block without suction. Improving the yield of this technique and comparing the yield with and without suction is important as we start testing for a greater number of mutations.