Role of Rebiopsy in Relapsed Non-Small Cell Lung Cancer for Directing Oncology Treatments

Abstract

Background. Currently, few rebiopsies are performed in relapses of advanced non-small cell lung cancer. They are not customary in clinical practice of lung cancer. However, it is not possible to properly target treatments in cases of relapse without knowing the nature of new lesions. Design. This paper comprehensively summarizes the available literature about rebiopsy and broadly discusses the importance of rebiopsy in advanced non-small cell lung cancer. Results. Altogether 560 abstracts were used as material for further analysis. 19 articles were about clinical rebiopsy in lung cancer and were reviewed in detailed manner. Conclusions. This review shows that rebiopsy is feasible in non-small cell lung cancer, and success rates can be high if rebiopsy is accompanied by adequate evaluation before biopsy. Its use may resolve the difficulties in sampling bias and detecting changes in cancer characteristics. In cases where treatment was selected based on tissue characteristics that then change, the treatment selection process must be repeated while considering new characteristics of the tumor. Rebiopsy may be used to predict therapeutic resistance and consequently redirect targeted therapies. Such knowledge may resolve the difficulties in sampling bias and also in selecting preexisting clones or formulating drug-resistant ones. Rebiopsy should be performed more often in non-small cell lung cancer.

Complications and Economic Burden Associated with Obtaining Tissue for Diagnosis and Molecular Analysis in Patients with Non-Small Cell Lung Cancer (NSCLC) in the US (Preprint)

“…Nevertheless, our data indicate that post-progression biopsies were not common practice in NSCLC from 2006 to 2014 [16], which is reflected by the rate of diagnostic biopsy vs the rate of post-progression biopsy (67.01% vs 10.27%, respectively). However, the use of mandatory biopsies throughout a patient's treatment is expected to increase as biomarker-driven drug approvals become the norm [16].…”

“…However, the use of mandatory biopsies throughout a patient's treatment is expected to increase as biomarker-driven drug approvals become the norm [16]. Osimertinib is a third-generation, EGFR-TKI that potently and selectively inhibits both EGFR sensitizing and EGFR T790M resistance mutations [5,17,18].…”

Case report: dermatomyositis associated with lung cancer with heterogeneous morphology

“…The relation of tumor heterogeneity with systemic chemotherapy drugs has not been systematically studied; however, after systemic chemotherapy the genetic profiles of cancer cells changed and the tumor heterogeneity increased (7-9). The drug resistance was reversible when a second biopsy was performed, which may confirm the nature of the lesions and prompt better treatment (10,11). In this case, having received S-1 triple therapy for approximately 1 year, there were signs of slightly increased lesions.…”

Management of Egfr-Mutated Non-Small-Cell Lung Cancer: Practical Implications from a Clinical and Pathology Perspective

“…Fine-needle aspiration cytology provides 100 mg of tissue compared with 100-200 mg of tissue from a core biopsy 41 . Fresh-frozen core biopsies provide 3.9 μg dna, formalin-fixed core biopsies provide 1.69 μg, and fna provides 0.23 μg.…”