Rebiopsy in advanced non-small cell lung cancer, clinical relevance and prognostic implications

医学 肿瘤科 内科学 肺癌 生物标志物 ROS1型 临床意义 阶段(地层学) 人口 癌症 队列 腺癌 古生物学 生物化学 化学 环境卫生 生物
作者
Matthias Scheffler,Marcel Wiesweg,Sebastian Michels,Lucia Nogová,Anna Kron,Thomas Herold,Andreas H. Scheel,Martin Metzenmacher,Wilfried Eberhardt,Henning Reis,Jana Fassunke,Kaid Darwiche,Clemens Aigner,Diana Schaufler,Richard Riedel,R. Fischer,Sophia Koleczko,Hans–Ulrich Schildhaus,Sabine Merkelbach‐Bruse,Kurt Werner Schmid,Reinhard Büttner,Jürgen Wolf,Martin Schüler
出处
期刊:Lung Cancer [Elsevier]
卷期号:168: 10-20 被引量:9
标识
DOI:10.1016/j.lungcan.2022.04.006
摘要

Rebiopsies of non-small cell lung cancers (NSCLC) are mainly performed to (i) cover the evolution of potentially amenable resistance mechanisms against a targeted therapy, and (ii) to identify new therapeutic targets which were not detected in the initial diagnostic biopsy. Comprehensive systematic analyses evaluating the value of rebiopsies are missing.Clinical databases from two large comprehensive cancer center networks were queried following prespecified criteria to identify prospectively entered NSCLC cases with at least one rebiopsy at disease progression. Clinicopathological and biomarker findings including multigene sequencing were correlated with clinical outcomes.From a total of 17,477 stage IV NSCLC patients, a cohort of 403 evaluable patients undergoing at least one rebiopsy of a primary tumor or metastasis was retrieved. Changes in biomarker profiles as compared to baseline were observed in 48.9%. In 31.3% of cases, findings of potential therapeutic relevance were revealed, including 18 patients (4.4%) with a targetable marker only detected at rebiopsy. New findings were more frequent (greater than50%) in NSCLC with EGFR/ALK/ROS1 alterations, including mutations of the dominant oncogene, TP53 mutations, and MET or ERBB2 amplifications. Patients undergoing rebiopsy exhibited superior overall survival compared to a control group, irrespective of presence (HR 0.28) or absence (HR 0.20, both p < 0.001) of a therapeutically targetable aberration.Rebiopsies at progression of advanced NSCLC are strongly supported by a high rate of clinically relevant findings. Current clinical practice selects a patient population with exceptional outcomes, which merits further characterization.
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