Adequacy of samples obtained via percutaneous core-needle rebiopsy for EGFR T790M molecular analysis in patients with non-small cell lung cancer following acquired resistance to first-line therapy: A systematic review and meta-analysis

Poudel, Bibhav; Desman, Jacob; Aihara, Gohta; Weidman, Deborah I.; Tsang, Ashley T.; Kovrizhkin, Katia; Pereira, Tatiana Cunha; Arun, Siddharth; Pradeep, Tejus; Matin, Shababa; Liddell, Robert P.

doi:10.1016/j.ctarc.2021.100470

Cited by 3 publications

(5 citation statements)

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“…One meta‐analysis including five studies showed that the pooled adequacy rate of samples was 86.92%, and the pooled T790M detection rate was 46.0%. However, complication rates of up to 20% have been reported 8 …”

Section: Discussionmentioning

confidence: 99%

“…However, complication rates of up to 20% have been reported. 8 EBUS-TBNA has been widely used for sampling mediastinal and hilar lymph nodes. The sensitivity, specificity, and accuracy of EBUS-TBNA for diagnosing malignant lymph nodes are 95.7%, 100%, and 97.1%, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…It is important to collect adequate cancer tissue to analyze the T790M mutation. Although percutaneous core needle biopsy has a high sample adequacy rate at re‐biopsy, complications occur frequently 8 …”

Section: Introductionmentioning

confidence: 99%

“…Although percutaneous core needle biopsy has a high sample adequacy rate at re-biopsy, complications occur frequently. 8 Endobronchial ultrasound with a guide sheath (EBUS-GS) and EBUS-guided transbronchial needle aspiration (EBUS-TBNA) are widely used to obtain samples of peripheral pulmonary lesions and mediastinal and hilar lymph nodes, respectively. 9 However, only one previous study with a small number of patients focused on the efficacy and safety of EBUS-guided re-biopsy after failed EGFR-TKI therapy.…”

Section: Introductionmentioning

confidence: 99%

“…Although percutaneous core needle biopsy has a high sample adequacy rate at re‐biopsy, complications occur frequently. 8 …”

Section: Introductionmentioning

confidence: 99%

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Endobronchial ultrasound‐guided re‐biopsy of non–small cell lung cancer with acquired resistance after EGFR tyrosine kinase inhibitor treatment

et al. 2022

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Background: Few studies assessed the use of endobronchial ultrasound (EBUS)guided re-biopsy for detecting the T790M mutation after epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) failure. Methods: A total of 2996 EBUS procedures were performed during the study period (January 2019-June 2022). In total, 44 consecutive patients who underwent EBUSguided re-biopsy (56 procedures) for detecting the T790M mutation were analyzed. The success rates and T790M mutation frequencies were analyzed according to the re-biopsy site and EBUS method. Multivariate logistic regression analyses were used to identify factors affecting the likelihood of the T790M mutation. Results: The success rates for the mutation analyses using EBUS with a guide-sheath (EBUS-GS), EBUS guided transbronchial needle aspiration (EBUS-TBNA), and EBUS-GS with EBUS-TBNA for re-biopsy were 80.6% (29/36), 93.3% (14/15), and 100% (5/5), respectively. Patients who underwent lymph node biopsy using EBUS-TBNA had an increased rates of the T790M mutation compared with those undergoing lung biopsy using EBUS-GS (EBUS-TBNA, 60.0%; EBUS-GS with EBUS-TBNA, 40.0%; EBUS-GS, 11.1%; p < 0.001). In multivariate analysis, the use of a firstgeneration EGFR-TKI (odds ratio [OR], 4.29; 95% confidence interval [CI], 1.05-17.58; p = 0.043) was associated with occurrence of the T790M mutation. Re-biopsy of the metastatic site tended to be associated with a higher T790M mutation rate. Mild hemoptysis occurred in 3.6% (2/56) of the patients. Conclusions: EBUS-guided re-biopsy can be used for detecting the T790M mutation in patients who failed EGFR-TKI therapy. The T790M mutation frequency differed according to the re-biopsy site. The use of a first-generation EGFR-TKI was an independent predictor of the T790M mutation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Although percutaneous core needle biopsy has a high sample adequacy rate at re‐biopsy, complications occur frequently. 8 …”

Section: Introductionmentioning

confidence: 99%

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Endobronchial ultrasound‐guided re‐biopsy of non–small cell lung cancer with acquired resistance after EGFR tyrosine kinase inhibitor treatment

et al. 2022

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Role of Image-Guided Percutaneous Needle Biopsy in the Age of Precision Medicine

Sone¹,

Sugawara²,

Yatabe

2022

Curr Oncol Rep

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The Feasibility of Interventional Pulmonology Methods for Detecting the T790M Mutation after the First or Second-Generation EGFR-TKI Resistance of Non-Small Cell Lung Cancer

et al. 2022

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The development of third-generation epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs) targeting T790M-mutant non-small cell lung cancer (NSCLC) has raised the importance of re-biopsy after EGFR-TKI failure. This study aimed to investigate the feasibility of interventional pulmonology (IP) procedures as re-biopsy methods for identifying the T790M mutation in EGFR-TKI-resistant patients. One hundred and thirty-nine NSCLC patients who underwent IP procedures for re-biopsy as their initial investigation after EGFR-TKI treatment failure were enrolled in this study between January 2020 and August 2022. All patients underwent a first re-biopsy with IP methods, with a diagnostic yield of 81.2% and T790M mutation detection rate of 36%. Thirty patients underwent a second re-biopsy; IP methods were used for 17 (56.6%) patients and non-IP methods for 13 (43.4%) patients; the T790M mutation detection rate was 36.4%. Only six patients underwent a third re-biopsy; no T790M mutation was noted. The T790M mutation detection rate did not differ between IP and non-IP methods (33.6 % vs. 37.5%, p = 0.762). In 11 cases (7.5%), a re-biopsy revealed histologic transformation from lung adenocarcinoma. IP procedures, as first-line re-biopsy methods for NSCLC, are feasible and provide sufficient tissue for identification of the resistance mechanism and target gene T790M mutation.

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Adequacy of samples obtained via percutaneous core-needle rebiopsy for EGFR T790M molecular analysis in patients with non-small cell lung cancer following acquired resistance to first-line therapy: A systematic review and meta-analysis

Cited by 3 publications

References 46 publications

Endobronchial ultrasound‐guided re‐biopsy of non–small cell lung cancer with acquired resistance after EGFR tyrosine kinase inhibitor treatment

Endobronchial ultrasound‐guided re‐biopsy of non–small cell lung cancer with acquired resistance after EGFR tyrosine kinase inhibitor treatment

Role of Image-Guided Percutaneous Needle Biopsy in the Age of Precision Medicine

The Feasibility of Interventional Pulmonology Methods for Detecting the T790M Mutation after the First or Second-Generation EGFR-TKI Resistance of Non-Small Cell Lung Cancer

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