1. Maximizing the clinical utility and performance of cytology samples for comprehensive genetic profiling.
- Author
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Kim D, Vanderbilt CM, Yang SR, Nandakumar S, Nafa K, Feratovic R, Rekhtman N, Rijo I, Casanova J, Yun A, Brannon AR, Berger MF, Ladanyi M, Lin O, and Arcila ME
- Subjects
- Humans, Biomarkers, Tumor genetics, Cell-Free Nucleic Acids genetics, DNA, Neoplasm genetics, Cytodiagnosis methods, Female, Neoplasms genetics, Neoplasms pathology, Neoplasms diagnosis, High-Throughput Nucleotide Sequencing methods, High-Throughput Nucleotide Sequencing standards
- Abstract
Comprehensive molecular profiling by next-generation sequencing has revolutionized tumor classification and biomarker evaluation. However, routine implementation is challenged by the scant nature of diagnostic material obtained through minimally invasive procedures. Here, we describe our long-term experience in profiling cytology samples with an in-depth assessment of the performance, quality metrics, biomarker identification capabilities, and potential pitfalls. We highlight the impact of several optimization strategies to maximize performance with 4,871 prospectively sequenced clinical cytology samples tested by MSK-IMPACT
TM . Special emphasis is given to the use of residual supernatant cell-free DNA (ScfDNA) as a valuable source of tumor DNA. Overall, cytology samples are similar in performance to surgical samples in identifying clinically relevant genomic alterations, achieving success rates up to 93% with full optimization. While cell block (CB) samples have excellent performance overall, low-level cross-contamination is identified in a small proportion of cases (4.7%), a common pitfall intrinsic to the processing of paraffin blocks, suggesting that more stringent precautions and processing modifications should be considered in quality control initiatives. By contrast ScfDNA samples have negligible contamination. Finally, ScfDNA testing exclusively used as a rescue strategy, delivered successful results in 71% of cases where tumor tissue from CB was depleted., Competing Interests: Competing interests: C.V. reports intellectual property rights and equity interest in Paige.AI, Inc. A.R.B. has ownership/equity interests in Johnson and Johnson. M.B. has received advisory or consulting fees from AstraZeneca, Eli Lilly and Company, and PetDx, Inc. M.L. has received advisory or consulting fees from Takeda Oncology, Janssen Pharmaceuticals, AstraZeneca, ADC Therapeutics, Paige.AI, Merck, Bayer, and Lilly Oncology and has received research funding from Loxo Oncology, Helsinn Therapeutics, Merus NV, Elevation Oncology, and Rain Therapeutics. O.L. has received advisory or consulting fees from Hologic and Janssen Research & Development, LLC. M.A. has received advisory or consulting fees from Axis Medical Education, Clinical Education Alliance, LLC, Merck Sharp & Dohme, PeerView Institute for Medical Education (PVI), Physicians’ Education Resource, RMEI Medical Education, LLC, and Roche. The following Authors declare no competing interests: D.K., S.Y., S.N., K.N., R.F., N.R., I.R., J.C., and A.Y., (© 2024. The Author(s).)- Published
- 2025
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