Diagnostic yield of endobronchial ultrasound-guided transbronchial needle aspiration to assess tumor-programmed cell death ligand-1 expression in mediastinal lymph nodes metastasized from non-small cell lung cancer

Mineura, Katsutaka; Hamaji, Masatsugu; Yoshizawa, Akihiko; Nakajima, N.; Kayawake, Hidenao; Tanaka, Satona; Yamada, Yoshito; Yutaka, Yojiro; Nakajima, Daisuke; Ohsumi, Akihiro; Menju, Toshi; Chen‐Yoshikawa, Toyofumi F.; Date, Hiroshi

doi:10.1007/s00595-020-01989-6

Cited by 10 publications

(10 citation statements)

References 32 publications

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“…In our series, the adequacy of EBUS-TBNA cytologies for genetic testing was high, above 90% for both NGS and nCounter, and was in line with other previously published studies ( Supplementary Table S3 [ 24 , 25 , 26 , 27 , 28 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 ]). Molecular results in cytology fully agreed with that of tissue testing, including some EGFR , BRAF , and MET ∆ex14 alterations, endorsing cytologies as an optimal source of material for genetic testing.…”

Section: Discussionsupporting

confidence: 92%

EBUS-TBNA Cytological Samples for Comprehensive Molecular Testing in Non–Small Cell Lung Cancer

Martín-Deleon

Teixidó

Lucena

et al. 2021

Cancers

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Clinical guidelines promote the identification of several targetable biomarkers to drive treatment decisions in advanced non-small cell lung cancer (NSCLC), but half of all patients do not have a viable biopsy. Specimens from endobronchial-ultrasound transbronchial needle aspiration (EBUS-TBNA) are an alternative source of material for the initial diagnosis of NSCLC, however their usefulness for a complete molecular characterization remains controversial. EBUS-TBNA samples were prospectively tested for several biomarkers by next-generation sequencing (NGS), nCounter, and immunohistochemistry (PD-L1). The primary objectives were to assess the sensitivity of EBUS-TBNA samples for a comprehensive molecular characterization and to compare its performance to the reference standard of biopsy samples. Seventy-two EBUS-TBNA procedures were performed, and 42 NSCLC patients were diagnosed. Among all cytological samples, 92.9% were successfully genotyped by NGS, 95.2% by nCounter, and 100% by immunohistochemistry. There were 29 paired biopsy samples; 79.3% samples had enough tumor material for genomic genotyping, and 96.6% for PD-L1 immunohistochemistry. A good concordance was found between both sources of material: 88.9% for PD-L1, 100% for NGS and nCounter. EBUS-TBNA is a feasible alternative source of material for NSCLC genotyping and allows the identification of patient candidates for personalized therapies with high concordance when compared with biopsy.

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Section: Discussionsupporting

confidence: 92%

EBUS-TBNA Cytological Samples for Comprehensive Molecular Testing in Non–Small Cell Lung Cancer

Martín-Deleon

Teixidó

Lucena

et al. 2021

Cancers

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“…Some studies doubt the predictive value of PD-L1 expression on metastasis lymph nodes, 7,8 but the results are inconsistent. 20,21 In our study, the ORR and PFS of patients with different PD-L1 expression levels tested on EBUS-TBNA specimens were similar. Despite the limited number of cases, the predictive value of EBUS-TBNA sample still needs to be evaluated further.…”

Section: Discussionsupporting

confidence: 59%

Feasibility and reliability of evaluate PD‐L1 expression determination using small biopsy specimens in non‐small cell lung cancer

Chen

Zhao

et al. 2021

Thoracic Cancer

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Background: Programmed cell death ligand-1 (PD-L1) is a useful biomarker in nonsmall cell lung cancer (NSCLC) patients who would probably benefit from immunotherapy. In most patients with advanced stage NSCLC, only small biopsy specimens were available for the evaluation of PD-L1 expression. In this study, we evaluated the feasibility and reliability of PD-L1 testing on small biopsy samples. Methods: Small specimens of advanced NSCLC patients obtained via endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), endobronchial biopsy (EBB), or computed tomography (CT)-guided core-needle biopsy were collected. Tumor cell count and tissue sufficiency for PD-L1 immunohistochemistry (IHC) were evaluated and compared. The clinical course of patients who received immunotherapy in the study population was also examined. Results: Tissue acquisitions for PD-L1 testing in three groups were all above 90%, with no statistically significant differences. The PD-L1 expressions levels were concordant in most patients with more than one sample (8/11). In the EBB group, PD-L1-positive patients had higher objective response rate (ORR) (53.2% vs. 26.9%, p = 0.048) and longer progression-free survival (PFS) (312 vs. 179 days, p = 0.035) than PD-L1 negative patients. In the core needle biopsy group, patients with positive PD-L1 expression also trended to have higher ORR and longer PFS. However, in the EBUS-TBNA group, both ORR and PFS were similar between patients with positive or negative PD-L1 expression. Conclusions: This study showed that EBUS-TBNA, EBB, and core needle biopsy provides adequate samples for PD-L1 testing. The predictive value of PD-L1 expression on different small samples still warrants further studies.

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“…PD-L1 mutation of >50% was detected in 25.6% (11/43) patients with primary lung adenocarcinoma which is comparable to rates seen in other studies. 13,14,12 In common with many EBUS centres, ROSE was not available at our institution. Our sample adequacy rate suggests that, although ROSE is desirable as it allows sample adequacy to be assessed contemporaneously and may reduce the number of needle punctures performed, it is not essential for obtaining adequate samples for PD-L1 analysis.…”

Section: Follow-upmentioning

confidence: 99%

Suitability of endobronchial ultrasound‐guided transbronchial needle aspiration samples for programmed death ligand‐1 testing in non‐small cell lung cancer, the Bristol experience

Hardy

Bhatt

Medford

2021

Asia-Pac J Clncl Oncology

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Treatment for non-small cell lung cancer (NSCLC) is now personalised using molecular mutation testing. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) biopsy suitability for anaplastic lymphoma kinase (ALK) and epidermal growth factor receptor (EGFR) mutation testing is established. Less is currently known about EBUS-TBNA suitability for PD-L1 (programmed death ligand-1) testing.To assess EBUS-TBNA biopsy adequacy for ALK, EGFR and PD-L1 testing, we conducted a prospective study of 279 consecutive NSCLC patients referred to a tertiary EBUS-TBNA centre in South West England. One hundred eight-four (62.6%) patients were found to have adenocarcinoma, 83 (28.2%) had squamous cell carcinoma, and 27 (9.2%) were identified as NSCLC-not otherwise specified. EGFR testing was successful in 166 of 168 patients (98.8%), ALK testing in all 115 and PD-L1 testing in 43 of 49 patients (88.2%).Previous EGFR and ALK testing did not affect biopsy PD-L1 testing success. PD-L1 testing failures occurred in three of five (60.0%) of 22G needle biopsies, one of five (20.0%) of 21G needle biopsies and two of 39 (5.1%) of 19G needle biopsies, P = .016. EBUS-TBNA biopsies are mostly suitable for PD-L1 testing. Larger needle size may improve PD-L1 (but not EGFR and ALK) testing success but requires further study in a controlled trial.

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Diagnostic yield of endobronchial ultrasound-guided transbronchial needle aspiration to assess tumor-programmed cell death ligand-1 expression in mediastinal lymph nodes metastasized from non-small cell lung cancer

Cited by 10 publications

References 32 publications

EBUS-TBNA Cytological Samples for Comprehensive Molecular Testing in Non–Small Cell Lung Cancer

EBUS-TBNA Cytological Samples for Comprehensive Molecular Testing in Non–Small Cell Lung Cancer

Feasibility and reliability of evaluate PD‐L1 expression determination using small biopsy specimens in non‐small cell lung cancer

Suitability of endobronchial ultrasound‐guided transbronchial needle aspiration samples for programmed death ligand‐1 testing in non‐small cell lung cancer, the Bristol experience

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