Abstract
Introduction Mini-invasive bronchoscopic techniques (such as radial endobronchial ultrasonography (rEBUS) and electromagnetic navigation (EMN)) have been developed to reach the peripheral lung but result in small samples. The feasibility of an adequate molecular testing from these specimens has been very little studied.
Methods We retrospectively reviewed EMN and rEBUS procedures performed in patients diagnosed with lung cancer in our institution in 2017 and 2018. We analysed the sensitivity for rEBUS and EMN and each sampling method, and the feasibility of a comprehensive molecular testing.
Results 317 rEBUS and 14 EMN were performed. Median sizes of tumors were 16 and 32 mm for EMN and rEBUS, respectively. Overall sensitivity for rEBUS and EMN was 84.3%. Cytology was found to be complementary with biopsies, with 13.3% of cancer diagnosed on cytology while biopsies were negative. Complication rate was 2.4% (pneumothorax 1.5%, mild hemoptysis 0.9%). Genotyping (immunohistochemistry (IHC) for ROS1 and ALK followed by FISH if positive and hybrid capture next-generation sequencing (NGS) covering 48-genes), when ordered (n=188), was feasible in 69.1% (EGFR 17.7%, KRAS 31.7%, BRAF 4.8%, ALK 1.2%, MET 3.1%, HER2 0.8%). PD-L1 expression, when ordered (n=232), could be analysed in 94% of cases. 56.9% (33/58) of patients for whom genotyping was not feasible underwent a second sampling (12 pretreatment, 21 at progression), allowing for the detection of 6 actionable genotypes (5 EGFR, 1 MET).
Conclusion rEBUS and EMN are sensitive and safe procedures that result in limited samples, often not suitable for genotyping, highlighting the importance to integrate liquid biopsy in routine.
Footnotes
This manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.
Conflict of interest: Dr. Robin has nothing to disclose.
Conflict of interest: Dr. Mhanna has nothing to disclose.
Conflict of interest: Dr. Chaltiel has nothing to disclose.
Conflict of interest: Dr. Plat has nothing to disclose.
Conflict of interest: Dr. Héluain has nothing to disclose.
Conflict of interest: Dr. Basset has nothing to disclose.
Conflict of interest: Dr. Meilleroux has nothing to disclose.
Conflict of interest: Dr. Filleron has nothing to disclose.
Conflict of interest: Dr. Mazieres has nothing to disclose.
Conflict of interest: Dr. Hermant has nothing to disclose.
Conflict of interest: Dr. Guibert has nothing to disclose.
This is a PDF-only article. Please click on the PDF link above to read it.
- Received December 15, 2020.
- Accepted May 12, 2021.
- Copyright ©The authors 2021
This version is distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0. For commercial reproduction rights and permissions contact permissions{at}ersnet.org