Endobronchial ultrasound in the management of nonsmall cell lung cancer

Dooms, Christophe; Muylle, Inge; Yserbyt, Jonas; Ninane, Vincent

doi:10.1183/09059180.00001113

Cited by 21 publications

(10 citation statements)

References 74 publications

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“…Fine-needle aspirations or bronchoscopic biopsies are often insufficient for predictive biomarker validation. 20-23 Even when there is ample tissue, it may not accurately reflect the relevant biology. This can occur based on treatment emergent changes such as EGFR T790M mutations, which occurs after treatment with an EGFR inhibitor.…”

Section: Introductionmentioning

confidence: 99%

Non–small cell lung cancer clinical trials requiring biopsies with biomarker‐specific results for enrollment provide unique challenges

Spiegel

Goldman

Wolf

et al. 2017

Cancer

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Background Clinical trials in lung cancer increasingly require subjects to provide fresh tumor tissue as a prerequisite to enrollment. The effects of this requirement on enrollment rates, enrollment durations, and subject selection have not been fully elucidated. Methods We retrospectively reviewed data generated by patients who consented to one or more interventional lung cancer clinical trials the UCLA Jonsson Comprehensive Cancer Center between January 2013 and December 2014. Trials were considered to require a biopsy when enrollment was conditional on the procurement of tissue without intervening therapy between procurement and enrollment. Results: 311 patients underwent 368 screening incidents for one or more of 19 trials. Trials that required a new biopsy had a longer median screening duration (34 vs. 14 days) than trials that did not require a biopsy (p<0.001). Trials requiring a biopsy had a greater screen failure rate (49.1% v. 26.5%, p<0.001), largely driven by patients who did not undergo the required biopsy or lacked the required biomarker. Worsening performance status led to the majority of screen failures (56.5%) among biomarker-eligible patients. Conclusions: Although the scientific benefits of obtaining a new biopsy and requiring specific results for trial enrollment are clear, it leads to a lengthening of the screening period, which, in some cases, is associated with clinical decline prior to enrollment. Implications for the interpretation of data from studies of this design should be explored.

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Section: Introductionmentioning

confidence: 99%

Non–small cell lung cancer clinical trials requiring biopsies with biomarker‐specific results for enrollment provide unique challenges

Spiegel

Goldman

Wolf

et al. 2017

Cancer

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“…At least four needle aspiration passes per target lesion are recommended to provide sufficient tissue for genotyping. 13 Ideally, the pulmonary physician or radiologist performing the biopsy procedure is aliquoting the different biopsies to the laboratory in individual containers.…”

Section: Flexible Videobronchoscopymentioning

confidence: 99%

Diagnostic procedures for non-small-cell lung cancer (NSCLC): recommendations of the European Expert Group

Dietel

Bubendorf

Dingemans

et al. 2015

Thorax

160

159

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BackgroundThere is currently no Europe-wide consensus on the appropriate preanalytical measures and workflow to optimise procedures for tissue-based molecular testing of non-small-cell lung cancer (NSCLC). To address this, a group of lung cancer experts (see list of authors) convened to discuss and propose standard operating procedures (SOPs) for NSCLC.MethodsBased on earlier meetings and scientific expertise on lung cancer, a multidisciplinary group meeting was aligned. The aim was to include all relevant aspects concerning NSCLC diagnosis. After careful consideration, the following topics were selected and each was reviewed by the experts: surgical resection and sampling; biopsy procedures for analysis; preanalytical and other variables affecting quality of tissue; tissue conservation; testing procedures for epidermal growth factor receptor, anaplastic lymphoma kinase and ROS proto-oncogene 1, receptor tyrosine kinase (ROS1) in lung tissue and cytological specimens; as well as standardised reporting and quality control (QC). Finally, an optimal workflow was described.ResultsSuggested optimal procedures and workflows are discussed in detail. The broad consensus was that the complex workflow presented can only be executed effectively by an interdisciplinary approach using a well-trained team.ConclusionsTo optimise diagnosis and treatment of patients with NSCLC, it is essential to establish SOPs that are adaptable to the local situation. In addition, a continuous QC system and a local multidisciplinary tumour-type-oriented board are essential.

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“…The second major advance has evolved over the last 20 years with the advent and refinement of new technologies that have greatly improved the capabilities of flexible bronchoscopy. At the forefront of these new technologies is endobronchial ultrasound (45). In its various forms, endobronchial ultrasound has improved diagnostic yield for pulmonary masses, nodules, and intrathoracic adenopathy, thereby reducing the need for more invasive surgical interventions.…”

Section: Diagnosis and Stagingmentioning

confidence: 99%

AJRCCM: 100-Year Anniversary.The Shifting Landscape for Lung Cancer: Past, Present, and Future

Vachani

Sequist

Spira

2017

Am J Respir Crit Care Med

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The past century has witnessed a transformative shift in lung cancer from a rare reportable disease to the leading cause of cancer death among men and women worldwide. This historic shift reflects the increase in tobacco consumption worldwide, spurring public health efforts over the past several decades directed at tobacco cessation and control. Although most lung cancers are still diagnosed at a late stage, there have been significant advances in screening high-risk smokers, diagnostic modalities, and chemopreventive approaches. Improvements in surgery and radiation are advancing our ability to manage early-stage disease, particularly among patients considered unfit for traditional open resection. Arguably, the most dramatic progress has occurred on the therapeutic side, with the development of targeted and immune-based therapy over the past decade. This article reviews the major shifts in the lung cancer landscape over the past 100 years. Although many ongoing clinical challenges remain, this review will also highlight emerging molecular and imaging-based approaches that represent opportunities to transform the prevention, early detection, and treatment of lung cancer in the years ahead.

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Endobronchial ultrasound in the management of nonsmall cell lung cancer

Cited by 21 publications

References 74 publications

Non–small cell lung cancer clinical trials requiring biopsies with biomarker‐specific results for enrollment provide unique challenges

Non–small cell lung cancer clinical trials requiring biopsies with biomarker‐specific results for enrollment provide unique challenges

Diagnostic procedures for non-small-cell lung cancer (NSCLC): recommendations of the European Expert Group

AJRCCM: 100-Year Anniversary.The Shifting Landscape for Lung Cancer: Past, Present, and Future

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