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Molecular profiling of advanced non-small cell lung cancer in the era of immunotherapy approach: a multicenter Italian observational prospective study of biomarker screening in daily clinical practice
- Publication Year :
- 2021
-
Abstract
- AimsHeterogeneous implementation of molecular tests in current diagnostic algorithm at a European and international level is emerging as a major issue for efficient lung cancer molecular profiling.MethodsFrom May 2017 until October 2017, N=1612 patients referring to 13 Italian institutions were selected, at advanced stage non-small cell lung cancer (NSCLC), and prospectively evaluated. Principal endpoints were: the percentage of diagnoses performed on cytological and histological material, the proportion of requests for epidermal growth factor receptor (EGFR) mutational status, and resistance mutations detected on tissue and/or liquid biopsy samples after first-generation or second-generation tyrosine kinase inhibitors, the proportion of requests for anaplastic lymphoma kinase (ALK) gene rearrangements, ROS proto-oncogene 1 (ROS1) and Kirsten Rat Sarcoma (KRAS) determinations, the proportion of requests for programmed death-ligand1 (PD-L1) evaluation and, finally, the different assays used for the detection of EGFR mutations, ALK and ROS1 gene rearrangements and PD-L1 expression.ResultsOf 1325 patients finally included, only 50.8% requests were related to driver mutations with target agents already available in first-line at that preplanned time, while 49.2% were associated with PD-L1, ROS1, KRAS and others. Multiplex genomic assays (such as next-generation sequencing) were considered by all participating centres.ConclusionsTo the best of our knowledge, this is the first study in a ‘real-life daily practice’ involving both pathologists and oncologists evaluating routinely workflow and trends towards improvements in molecular requests. Collected data aim to describe the applied algorithms and evolution of molecular screening for stage IV NSCLC in clinical practice.
- Subjects :
- Oncology
medicine.medical_specialty
EGFR
immunohistochemistry
lung neoplasms
molecular
molecular biology
pathology
medicine.disease_cause
Pathology and Forensic Medicine
03 medical and health sciences
0302 clinical medicine
Internal medicine
Carcinoma, Non-Small-Cell Lung
Proto-Oncogene Proteins
medicine
ROS1
Anaplastic lymphoma kinase
Humans
030212 general & internal medicine
Epidermal growth factor receptor
Prospective Studies
Liquid biopsy
Prospective cohort study
Lung cancer
Early Detection of Cancer
biology
business.industry
General Medicine
Protein-Tyrosine Kinases
medicine.disease
030220 oncology & carcinogenesis
Mutation
biology.protein
Biomarker (medicine)
KRAS
Immunotherapy
business
Biomarkers
Subjects
Details
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....249e604a532943d32f25ec94753fbe0c