EUS fine-needle pancreatic core biopsy can determine eligibility for tumor-agnostic immunotherapy

Gleeson, Ferga C.; Levy, Michael J.; Roden, Anja C.; Boardman, Lisa A.; Sinicrope, Frank A.; McWilliams, Robert R.; Zhang, Lizhi

doi:10.1055/a-0650-4447

Cited by 13 publications

(16 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Additionally, the tissue obtained via FNB can be helpful in molecular profiling of the tumor and evaluation of biomarkers to aid in the management of the patient. A recent study concluded that EUS‐FNB specimens of PDAs were adequate for mismatch repair protein and programmed death ligand‐1 immunohistochemistry in 97.2% and 94.9% cases, respectively . Tiriac and colleagues have even shown that pancreatic cancer organoids can be successfully created from FNB samples at the time of initial tissue diagnosis for enhancing personalized treatment options …”

Section: Discussionmentioning

confidence: 99%

“…In comparison with FNA, FNB may be more useful in diagnosing well-differentiated PDAs as it clearly reveals the histologic architec- concluded that EUS-FNB specimens of PDAs were adequate for mismatch repair protein and programmed death ligand-1 immunohistochemistry in 97.2% and 94.9% cases, respectively. 26 Tiriac and colleagues have even shown that pancreatic cancer organoids can be successfully created from FNB samples at the time of initial tissue diagnosis for enhancing personalized treatment options. 27 In the non-neoplastic group, autoimmune pancreatitis was given a descriptive diagnosis on FNA.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Endoscopic ultrasound‐guided tissue acquisition of solid mass lesions of the pancreas: A retrospective comparison study of fine‐needle aspiration and fine‐needle biopsy

Sweeney

Soong

Goyal

2020

Diagnostic Cytopathology

View full text Add to dashboard Cite

Background Although endoscopic ultrasound guided fine‐needle biopsy (EUS‐FNB) has emerged as an alternative to fine‐needle aspiration (FNA) for the sampling of solid pancreatic mass lesions, it remains unclear which method is more effective. We compared the diagnostic yields of FNA, FNB, and combined FNA/FNB at a tertiary care institution. Methods Specimens from EUS‐FNA (04/2014‐08/2017) and EUS‐FNB (10/2015‐08/2017) with SharkCore needle of pancreatic solid mass lesions were retrieved. Clinical, radiologic, and pathologic data was recorded. Pathology results of malignancy/neoplasms with uncertain malignant potential were considered as true positive. The “negative” cases included were with ≥6 months of follow‐up. Nondiagnostic cases showed unremarkable pancreatic tissue, nonpancreatic elements, atypia, or features suspicious for malignancy. Diagnostic yield was defined as percentage of lesions sampled in which a benign or malignant tissue diagnosis, as defined above, was obtained. Statistical comparisons were performed using Fisher's exact test and univariable and multivariable logistic regression analysis. Results The study cohort included 76 FNA only cases, 88 FNB only cases, and 40 combined FNA/FNB cases. Diagnostic yields were 70% (FNA), 70% (FNB), and 83% (FNA/FNB), which were not statistically different. Increase in lesion size and presence of ROSE were significantly associated with a diagnostic outcome on both univariable and multivariable analysis, unlike the number of passes. Conclusion Our results demonstrate that for solid pancreatic lesions, the diagnostic yields of FNA, FNB, and combined FNA and FNB are comparable. Presence of ROSE and increasing lesion size increased the diagnostic yield while the number of passes had no significant impact.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Endoscopic ultrasound‐guided tissue acquisition of solid mass lesions of the pancreas: A retrospective comparison study of fine‐needle aspiration and fine‐needle biopsy

Sweeney

Soong

Goyal

2020

Diagnostic Cytopathology

View full text Add to dashboard Cite

show abstract

“…In a previous study at least 3% of malignant pancreas lesions were sensitive to pembrolizumab and more than 8% were sensitive to the family of immune checkpoint inhibitors. Due to the large EUS-FNB tissue samples precision immuno-oncology can be applied to these patients (PD-L1 evaluation is performed in large tissue samples) 15. The far upstream element-binding protein 1 (FUBP1) is an important transactivator of c-Myc proto-oncogene.…”

Section: Molecular Pathwaysmentioning

confidence: 99%

Update on current pancreatic treatments: from molecular pathways to treatment

et al. 2019

View full text Add to dashboard Cite

Pancreatic cancer is still diagnosed at a late stage although we have novel diagnostic tools. Pancreatic cancer chemotherapy treatment resistance is observed and therefore novel treatments are in need. Anti-cancer stem cell therapy, combination of chemotherapy and/or radiotherapy with immunotherapy, proteins/enzymes and gene therapy are currently under evaluation. Targeted treatment with tyrosine kinase inhibitors is also administered and novel inhibitors are also under evaluation. In the current review we present recent data from our search within the year 2018.

show abstract

“…According to some authors, this procedure is both safe and accurate and it enables pathologists to obtain abundant material to perform morphological diagnosis on and to carry out immunohistochemical analyses especially in difficult cases like well-differentiated adenocarcinomas, mesenchymal tumors, autoimmune pancreatitis, or lymphoma [10]. Moreover, the preservation of histological material may guarantee, in the near future, the possibility to test it for novel targeted therapies [3, 11, 12]. Despite numerous published data, it remains unclear which is the best method to apply, therefore, we propose to compare FNA and FNB procedures or their combination to understand which could be the most appropriate 1 to choose.…”

Section: Introductionmentioning

confidence: 99%

Fine Needle Aspiration versus Fine Needle Biopsy of Biliopancreatic Lesions: Are They Really Opposing Techniques or Can They Be Complementary? Our Experience in a Large Cohort of Cases from a Single Institution

et al. 2020

View full text Add to dashboard Cite

Introduction: Nowadays, endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA), and fine needle biopsy (FNB) are considered the best procedures for the diagnosis of biliopancreatic lesions. These methods represent a milestone since they proved to be both safe for the patient and useful to achieve diagnostic material useful to plan the best treatment strategy. Objective: Since in the literature, a debate between cytology and histology supporters is still ongoing and the trend is changing in favor of FNB, we would like to present our experience about the diagnostic yield of FNA and FNB. The aim of our study is to highlight FNA versus FNB diagnostic role of biliopancreatic lesions, highlight advantages, and drawbacks of these procedures, and our view on these 2 procedures and whether they should still be considered complementary or opposing techniques. Methods: We retrospectively reviewed our hospital series of 469 EUS diagnostics procedures of biliopancreatic lesions performed in 419 patients, between 2015 and 2019. Results: The overall adequacy rates of FNA and FNB were, respectively, 98.9 and 100%. Stratifying cases according to anatomic location of the mass (pancreas vs. biliary system), we detected 168 malignancies out of 349 pancreatic lesions (168/349; 48.1%), while biliary system cases positive for malignancy represented 33.8% (23/68 cases) (p value = 0.045, χ2 test). As for concomitant FNB, our series displayed a high rate of diagnostic concordance (88.8%). Conclusions: Despite numerous data published, it is still unclear which is the most feasible method to use; therefore, we compared FNA, FNB, or their combination to understand the best applicable technique. Our experience confirmed that FNA is extremely efficient in the diagnosis of biliopancreatic lesions, especially in the hands of expert endoscopists and pathologists. Considering anatomic location, EUS-FNA is more accurate for mass-forming neoplasms in the pancreatic parenchyma rather than for lesions of the biliary system. Moreover, concomitant FNB usually confirmed the cytological diagnosis, allowing a deeper immunohistochemical characterization of the neoplasia. This proves that a “pure” cytology and “pure” histology approach should be looked differently since these are complementary techniques especially if we can obtain a cellblock from FNA.

show abstract

EUS fine-needle pancreatic core biopsy can determine eligibility for tumor-agnostic immunotherapy

Cited by 13 publications

References 16 publications

Endoscopic ultrasound‐guided tissue acquisition of solid mass lesions of the pancreas: A retrospective comparison study of fine‐needle aspiration and fine‐needle biopsy

Endoscopic ultrasound‐guided tissue acquisition of solid mass lesions of the pancreas: A retrospective comparison study of fine‐needle aspiration and fine‐needle biopsy

Update on current pancreatic treatments: from molecular pathways to treatment

Fine Needle Aspiration versus Fine Needle Biopsy of Biliopancreatic Lesions: Are They Really Opposing Techniques or Can They Be Complementary? Our Experience in a Large Cohort of Cases from a Single Institution

Contact Info

Product

Resources

About