Detection of tumor DNA in bronchoscopic fluids in peripheral non small cell lung cancer: a proof-of-concept study. Arhant, G., Lachkar, S., Thiebaut, P., Marguet, F., Lamy, A., Thiberville, L., Salaün, M., Guisier, F., Sabourin, J., & Piton, N. JTO Clinical and Research Reports, October, 2023.
Detection of tumor DNA in bronchoscopic fluids in peripheral non small cell lung cancer: a proof-of-concept study [link]Paper  doi  abstract   bibtex   
Background DNA Genotyping from plasma is a useful tool for molecular characterization of non-small cell lung cancer. However, the false negative rate justifies the development of methods with higher sensitivity, especially in difficult to reach peripheral lung tumours. Research question What is the added value of molecular analysis from fluid collected during r-EBUS for peripheral lung cancer, compared to biopsy and circulating tumour DNA analyses? Study design and methods We aimed at comparing molecular analysis from the supernatant of guide sheath flush fluid collected during r-EBUS bronchoscopy to plasma sampling and tumour biopsies in patients with peripheral non-small cell lung cancer. DNA was genotyped using high-throughput sequencing or the COBAS® Mutation Test. Sixty-five patients with peripheral lung tumours were subjected to concomitant sampling of guide sheath flush supernatant, plasma tumour DNA and tumour biopsy/cytology using r-EBUS. Thirty-three patients (including 24 newly diagnosed non-small cell lung cancers) with an identifiable tumour mutation in the primary lesion were selected for the comparative analysis. Results Guide sheath flush-based genotyping yielded a mutation detection rate of 61.8% (17/24 mutated EGFR, 1/2 ERBB2, 1/1 KRAS, 1/1 MAP2K, 1/4 MET, and 0/1 STK11), compared to 33% in plasma-based genotyping (p = 0.0151). Furthermore, in the 8/34 r-EBUS without tumor cells on microscopic examination, we were able to detect the mutation in 4 paired guide sheath flush supernatant, compared to only 2 in paired plasma. Interpretation The detection of tumor DNA in the supernatant of guide sheath flush fluid collected during r-EBUS bronchoscopy represents a sensitive and complementary method for genotyping non-small cell lung cancer.
@article{arhant_detection_2023,
	title = {Detection of tumor {DNA} in bronchoscopic fluids in peripheral non small cell lung cancer: a proof-of-concept study},
	issn = {2666-3643},
	shorttitle = {Detection of tumor {DNA} in bronchoscopic fluids in peripheral non small cell lung cancer},
	url = {https://www.sciencedirect.com/science/article/pii/S266636432300139X},
	doi = {10.1016/j.jtocrr.2023.100596},
	abstract = {Background
DNA Genotyping from plasma is a useful tool for molecular characterization of non-small cell lung cancer. However, the false negative rate justifies the development of methods with higher sensitivity, especially in difficult to reach peripheral lung tumours.
Research question
What is the added value of molecular analysis from fluid collected during r-EBUS for peripheral lung cancer, compared to biopsy and circulating tumour DNA analyses?
Study design and methods
We aimed at comparing molecular analysis from the supernatant of guide sheath flush fluid collected during r-EBUS bronchoscopy to plasma sampling and tumour biopsies in patients with peripheral non-small cell lung cancer. DNA was genotyped using high-throughput sequencing or the COBAS® Mutation Test. Sixty-five patients with peripheral lung tumours were subjected to concomitant sampling of guide sheath flush supernatant, plasma tumour DNA and tumour biopsy/cytology using r-EBUS. Thirty-three patients (including 24 newly diagnosed non-small cell lung cancers) with an identifiable tumour mutation in the primary lesion were selected for the comparative analysis.
Results
Guide sheath flush-based genotyping yielded a mutation detection rate of 61.8\% (17/24 mutated EGFR, 1/2 ERBB2, 1/1 KRAS, 1/1 MAP2K, 1/4 MET, and 0/1 STK11), compared to 33\% in plasma-based genotyping (p = 0.0151). Furthermore, in the 8/34 r-EBUS without tumor cells on microscopic examination, we were able to detect the mutation in 4 paired guide sheath flush supernatant, compared to only 2 in paired plasma.
Interpretation
The detection of tumor DNA in the supernatant of guide sheath flush fluid collected during r-EBUS bronchoscopy represents a sensitive and complementary method for genotyping non-small cell lung cancer.},
	urldate = {2024-01-23},
	journal = {JTO Clinical and Research Reports},
	author = {Arhant, Gwenaëlle and Lachkar, Samy and Thiebaut, Pierre-Alain and Marguet, Florent and Lamy, Aude and Thiberville, Luc and Salaün, Mathieu and Guisier, Florian and Sabourin, Jean-Christophe and Piton, Nicolas},
	month = oct,
	year = {2023},
	keywords = {Alamut, EGFR, Pulmonology, bronchoscopy, guide sheath flush, liquid biopsy, molecular biology, non-small cell lung carcinoma, peripheral lung nodule, radial-EndoBronchial UltraSound, targeted therapy, thoracic oncology, tumor DNA, tumor genotyping},
	pages = {100596},
}
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