Using Bronchoscopic Lung Cryobiopsy and a Genomic Classifier in the Multidisciplinary Diagnosis of Diffuse Interstitial Lung Diseases

Kheir, Fayez; Alkhatib, Ala; Berry, Gerald J.; Daroca, Philip J.; Diethelm, L; Rampolla, Reinaldo; Saito, Shigeki; Smith, David L.; Weill, David; Bateman, Marjorie; Abdelghani, Ramsy; Lasky, Joseph A.

doi:10.1016/j.chest.2020.05.532

Cited by 22 publications

(17 citation statements)

References 24 publications

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“…Because ILDs have multiple, overlapping pathophysiological pathways, the use of large-scale sequencing platforms that incorporate numerous biomarkers is an attractive approach. For example, the Envisia Genomic Classifier (Veracyte, San Francisco, CA, USA), which utilises a 190-gene expression signature to differentiate between UIP and non-UIP, has been demonstrated to significantly improve the diagnostic confidence of multidisciplinary teams in the management of patients with probable UIP [25][26][27][28][29]. An essential component of the validation of genomic classifiers is that their prognostic value is shown to be superior to routine baseline tests.…”

Section: Biomarkers and Technologies: Diagnostic Prognostic And Preci...mentioning

confidence: 99%

The role of precision medicine in interstitial lung disease

2022

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The management of interstitial lung disease (ILD) may benefit from a conceptual shift. Increased understanding of this complex and heterogeneous group of disorders over the past 20 years has highlighted the need for individualised treatment strategies that encompass diagnostic classification and disease behaviour. Biomarker-based approaches to precision medicine hold the greatest promise. Robust, large-scale biomarker-based technologies supporting ILD diagnosis have been developed, and future applications relating to staging, prognosis and assessment of treatment response are emerging. Artificial intelligence may redefine our ability to base prognostic evaluation on both diagnosis and underlying disease processes, sharpening individualised treatment algorithms to a level not previously achieved. Compared with therapeutic areas such as oncology, precision medicine in ILD is still in its infancy. However, the heterogeneous nature of ILD suggests that many relevant molecular, environmental and behavioural targets may serve as useful biomarkers if we are willing to invest in their identification and validation.

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Section: Biomarkers and Technologies: Diagnostic Prognostic And Preci...mentioning

confidence: 99%

The role of precision medicine in interstitial lung disease

2022

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“…chestjournal.org these less invasive samples. [13][14][15] However, despite its frequent reference in arguments against SLB, this substantial mortality rate is not representative of many centers, with a large percentage of ILD cohorts reporting no deaths after SLB. 16 Rates of other complications are similarly substantially reduced with careful patient selection and consideration of center-specific factors such as SLB volume.…”

Section: Determine Risk Of Complication From Slbmentioning

confidence: 99%

POINT: Should Surgical Lung Biopsy Still Be Performed for Interstitial Lung Disease Evaluation? Yes

Ryerson

2021

Chest

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“…However, it is unclear what role the molecular classifier has in subjects with an HRCT pattern with features most consistent with an alternative diagnosis. Based on our recent single-center experience, the GC did not add to IPF diagnostic confidence, when HRCT scans were indeterminate or more in keeping with an alternative diagnosis, and the multidisciplinary discussion likelihood of IPF was considered low ( 10 ). Additionally, false-negative GC results were more commonly seen when the pathology was discordant between different lobes.…”

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confidence: 99%