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Qiu T, Zhang F, Zheng B, Feng Z, Li W, Zeng H, Chu L, Ying J. Ultra-rapid Idylla™ EGFR mutation screening followed by next-generation sequencing: An integrated solution to molecular diagnosis of non-small cell lung cancer. Front Oncol 2023; 13:1064487. [PMID: 37064089 PMCID: PMC10102514 DOI: 10.3389/fonc.2023.1064487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Accepted: 03/21/2023] [Indexed: 04/03/2023] Open
Abstract
BackgroundRapid profiling of the EGFR mutations is crucial to help clinicians choose the optimal treatment for patients with advanced/metastatic Non-Small Cell Lung Cancer (NSCLC). Unfortunately, current diagnostic techniques, including ARMS-PCR and NGS, generally require several days to deliver final results. This diagnostic delay may lead to treatment delays for patients who are worsening rapidly.MethodsThis study introduced the ultra-rapid Idylla™ system for rapid, sensitive and specific identification of the EGFR mutations among Chinese NSCLC patients. Idylla™ EGFR Assay, an integrated cartridge running on the Idylla™ system, which can detect 51 EGFR mutations directly from Formalin-Fixed, Paraffin-Embedded (FFPE) samples within 2.5 hours, was used in this study. The sensitivity and specificity of the Idylla™ system were evaluated in comparison with ARMS-PCR or NGS using 95 clinical samples.ResultsThe Idylla™ system achieved a sensitivity of 97.6%, a specificity of 100%, and an overall concordance of 97.9% for 95 retrospective samples. When compared to ARMS-PCR, the Idylla™ system demonstrated high accuracy with an overall agreement of 97.1% (34/35), a sensitivity of 95.2% (20/21) (95% CI, 76.2% - 99.9%), and an estimated specificity of 100% (12/12) (95% CI, 76.8% - 100%) for 35 prospective samples.ConclusionsThis Idylla system provides a rapid, accurate and simple approach for screening EGFR mutations, which can guide Tyrosine Kinase Inhibitors (TKI) treatment for NSCLC patients in a timely manner.
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Affiliation(s)
- Tian Qiu
- *Correspondence: Tian Qiu, ; Jianming Ying,
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Banyi N, Alex D, Hughesman C, McNeil K, N. Ionescu D, Ma C, Yip S, Melosky B. Improving Time-to-Treatment for Advanced Non-Small Cell Lung Cancer Patients through Faster Single Gene EGFR Testing Using the Idylla™ EGFR Testing Platform. Curr Oncol 2022; 29:7900-7911. [PMID: 36290901 PMCID: PMC9600153 DOI: 10.3390/curroncol29100624] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 08/29/2022] [Accepted: 10/11/2022] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION Patients with advanced-stage non-small cell lung cancer (NSCLC) may benefit from a short time-to-treatment (TTT). Predictive biomarker testing is performed prior to treatment, as recommended by various international expert consensus bodies. Genetic testing is more time-intensive than immunohistochemistry (IHC) and commonly contributes to prolonged TTT. For epidermal growth factor receptor-positive patients (EGFR+), further genetic testing may not be required due to the mutual exclusivity of actionable mutations. METHODS The trial cohort (N = 238) received both BC Cancer NGS panel (Oncopanel) and Idylla EGFR testing. Data were also collected for a control cohort (N = 220) that received Oncopanel testing. For each patient, the time that the lab received the sample, the time taken to report the NGS and Idylla tests, the time of first treatment, and the final treatment regimen were recorded. RESULTS A concordance frequency of 98.7% (232/235) was observed between the Idylla and NGS panel. The lab turnaround time (TAT) was faster for the Idylla test by an average of 12.4 days (N = 235, p < 0.01). Overall, the average TTT in the trial cohort (N = 114) was 10.1 days faster (p < 0.05) than the control (N = 114), leading to a 25% reduction in TTT. For patients treated based on EGFR positivity, the mean TTT was 16.8 days faster (p < 0.05) in the trial cohort (N = 33) than the control cohort (N = 28), leading to a 48% reduction in TTT. CONCLUSION Using the Idylla EGFR test as part of the molecular testing repertoire in advanced-stage NSCLC patients could significantly reduce TTT.
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Affiliation(s)
- Norbert Banyi
- Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
- Department of Pathology, BC Cancer, Vancouver, BC V5Z 4E6, Canada
| | - Deepu Alex
- Department of Pathology, BC Cancer, Vancouver, BC V5Z 4E6, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC V6T 1Z7, Canada
- Cancer Genetics and Genomics Laboratory, BC Cancer, Vancouver, BC V5Z 4E6, Canada
| | - Curtis Hughesman
- Cancer Genetics and Genomics Laboratory, BC Cancer, Vancouver, BC V5Z 4E6, Canada
| | - Kelly McNeil
- Cancer Genetics and Genomics Laboratory, BC Cancer, Vancouver, BC V5Z 4E6, Canada
| | - Diana N. Ionescu
- Department of Pathology, BC Cancer, Vancouver, BC V5Z 4E6, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC V6T 1Z7, Canada
| | - Carmen Ma
- Medical Oncology, BC Cancer, Vancouver, BC V5Z 4E6, Canada
| | - Stephen Yip
- Department of Pathology, BC Cancer, Vancouver, BC V5Z 4E6, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC V6T 1Z7, Canada
- Cancer Genetics and Genomics Laboratory, BC Cancer, Vancouver, BC V5Z 4E6, Canada
| | - Barbara Melosky
- Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
- Medical Oncology, BC Cancer, Vancouver, BC V5Z 4E6, Canada
- Correspondence: ; Tel.: +1-604-877-6000; Fax: +1-604-877-0585
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Wolff HB, Steeghs EMP, Mfumbilwa ZA, Groen HJM, Adang EM, Willems SM, Grünberg K, Schuuring E, Ligtenberg MJL, Tops BBJ, Coupé VMH. Cost-Effectiveness of Parallel Versus Sequential Testing of Genetic Aberrations for Stage IV Non-Small-Cell Lung Cancer in the Netherlands. JCO Precis Oncol 2022; 6:e2200201. [PMID: 35834758 PMCID: PMC9307305 DOI: 10.1200/po.22.00201] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
PURPOSE A large number of targeted treatment options for stage IV nonsquamous non–small-cell lung cancer with specific genetic aberrations in tumor DNA is available. It is therefore important to optimize diagnostic testing strategies, such that patients receive adequate personalized treatment that improves survival and quality of life. The aim of this study is to assess the efficacy (including diagnostic costs, turnaround time (TAT), unsuccessful tests, percentages of correct findings, therapeutic costs, and therapeutic effectiveness) of parallel next generation sequencing (NGS)–based versus sequential single-gene–based testing strategies routinely used in patients with metastasized non–small-cell lung cancer in the Netherlands. METHODS A diagnostic microsimulation model was developed to simulate 100,000 patients with prevalence of genetic aberrations, extracted from real-world data from the Dutch Pathology Registry. These simulated patients were modeled to undergo different testing strategies composed of multiple tests with different test characteristics including single-gene and panel tests, test accuracy, the probability of an unsuccessful test, and TAT. Diagnostic outcomes were linked to a previously developed treatment model, to predict average long-term survival, quality-adjusted life-years (QALYs), costs, and cost-effectiveness of parallel versus sequential testing. RESULTS NGS-based parallel testing for all actionable genetic aberrations is on average €266 cheaper than single-gene–based sequential testing, and detects additional relevant targetable genetic aberrations in 20.5% of the cases, given a TAT of maximally 2 weeks. Therapeutic costs increased by €8,358, and 0.12 QALYs were gained, leading to an incremental cost-effectiveness ratio of €69,614/QALY for parallel versus sequential testing. CONCLUSION NGS-based parallel testing is diagnostically superior over single-gene–based sequential testing, as it is cheaper and more effective than sequential testing. Parallel testing remains cost-effective with an incremental cost-effectiveness ratio of 69,614 €/QALY upon inclusion of therapeutic costs and long-term outcomes.
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Affiliation(s)
- Henri B Wolff
- Department of Epidemiology and Biostatistics, Amsterdam University Medical Center, VU Amsterdam, Amsterdam, the Netherlands
| | - Elisabeth M P Steeghs
- Department of Pathology, Radboudumc, Nijmegen, the Netherlands.,Department of Pathology, Antoni van Leeuwenhoek Hospital, the Netherlands Cancer Institute, Amsterdam, the Netherlands.,Department of Pathology, Leiden University Medical Center, Leiden, the Netherlands
| | - Zakile A Mfumbilwa
- Department of Epidemiology and Biostatistics, Amsterdam University Medical Center, VU Amsterdam, Amsterdam, the Netherlands
| | - Harry J M Groen
- Department of Pulmonary Diseases, University of Groningen and University Medical Center Groningen, Groningen, the Netherlands
| | - Eddy M Adang
- Department of Epidemiology, Biostatistics and HTA, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Stefan M Willems
- Department of Pathology and Medical Biology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.,PALGA Foundation, Houten, the Netherlands
| | | | - Ed Schuuring
- Department of Pathology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Marjolijn J L Ligtenberg
- Department of Pathology, Radboudumc, Nijmegen, the Netherlands.,Department of Human Genetics, and Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Bastiaan B J Tops
- Princess Máxima Center for Pediatric Oncology, Bilthoven, the Netherlands
| | - Veerle M H Coupé
- Department of Epidemiology and Biostatistics, Amsterdam University Medical Center, VU Amsterdam, Amsterdam, the Netherlands
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4
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Bourhis A, Remoué A, Samaison L, Uguen A. Diagnostic mutationnel rapide Idylla™ : applications théranostiques actuelles et futures. Ann Pathol 2022; 42:329-343. [DOI: 10.1016/j.annpat.2021.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 12/07/2021] [Accepted: 12/12/2021] [Indexed: 10/19/2022]
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Petiteau C, Robinet-Zimmermann G, Riot A, Dorbeau M, Richard N, Blanc-Fournier C, Bibeau F, Deshayes S, Bergot E, Gervais R, Levallet G. Contribution of the Idylla TM System to Improving the Therapeutic Care of Patients with NSCLC through Early Screening of EGFR Mutations. Curr Oncol 2021; 28:4432-4445. [PMID: 34898548 PMCID: PMC8628756 DOI: 10.3390/curroncol28060376] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 10/22/2021] [Accepted: 11/02/2021] [Indexed: 12/13/2022] Open
Abstract
Epidermal growth factor receptor (EGFR) genotyping, a critical examen for the treatment decisions of patients with non-small cell lung cancer (NSCLC), is commonly assayed by next-generation sequencing (NGS), but this global approach takes time. To determine whether rapid EGFR genotyping tests by the IdyllaTM system guides earlier therapy decisions, EGFR mutations were assayed by both the IdyllaTM system and NGS in 223 patients with NSCLC in a bicentric prospective study. IdyllaTM demonstrated agreement with the NGS method in 187/194 cases (96.4%) and recovered 20 of the 26 (77%) EGFR mutations detected using NGS. Regarding the seven missed EGFR mutations, five were not detected by the IdyllaTM system, one was assayed in a sample with insufficient tumoral cells, and the last was in a sample not validated by the IdyllaTM system (a bone metastasis). IdyllaTM did not detect any false positives. The average time between EGFR genotyping results from IdyllaTM and the NGS method was 9.2 ± 2.2 working days (wd) (12.6 ± 4.0 calendar days (cd)). Subsequently, based on the IdyllaTM method, the timeframe from tumor sampling to the initiation of EGFR-TKI was 7.7 ± 1.2 wd (11.4 ± 3.1 cd), while it was 20.3 ± 6.7 wd (27.2 ± 8.3 cd) with the NGS method (p < 0.001). We thus demonstrated here that the IdyllaTM system contributes to improving the therapeutic care of patients with NSCLC by the early screening of EGFR mutations.
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Affiliation(s)
- Constance Petiteau
- Department of Pulmonology & Thoracic Oncology, Centre Hospitalier Universitaire de Caen, F-14000 Caen, France; (C.P.); (S.D.); (E.B.)
| | | | - Adèle Riot
- Department of Pathology, Centre Hospitalier Universitaire de Caen, F-14000 Caen, France; (A.R.); (F.B.)
| | - Marine Dorbeau
- Department of Pathology, Centre François Baclesse, F-14000 Caen, France; (G.R.-Z.); (M.D.); (C.B.-F.)
| | - Nicolas Richard
- Department of Genetics, Normandy University, UNICAEN, Caen University Hospital, EA 7450 BioTARGen, F-14000 Caen, France;
- Federative Structure of Cyto-Molecular Oncogenetics (SF-MOCAE), Centre Hospitalier Universitaire de Caen, F-14000 Caen, France
| | - Cécile Blanc-Fournier
- Department of Pathology, Centre François Baclesse, F-14000 Caen, France; (G.R.-Z.); (M.D.); (C.B.-F.)
| | - Frédéric Bibeau
- Department of Pathology, Centre Hospitalier Universitaire de Caen, F-14000 Caen, France; (A.R.); (F.B.)
| | - Simon Deshayes
- Department of Pulmonology & Thoracic Oncology, Centre Hospitalier Universitaire de Caen, F-14000 Caen, France; (C.P.); (S.D.); (E.B.)
| | - Emmanuel Bergot
- Department of Pulmonology & Thoracic Oncology, Centre Hospitalier Universitaire de Caen, F-14000 Caen, France; (C.P.); (S.D.); (E.B.)
- Normandy University, UNICAEN, CEA, CNRS, ISTCT Unit, GIP CYCERON, F-14000 Caen, France
| | - Radj Gervais
- Department of Thoracic Oncology, Centre François Baclesse, F-14000 Caen, France;
| | - Guénaëlle Levallet
- Department of Pathology, Centre Hospitalier Universitaire de Caen, F-14000 Caen, France; (A.R.); (F.B.)
- Federative Structure of Cyto-Molecular Oncogenetics (SF-MOCAE), Centre Hospitalier Universitaire de Caen, F-14000 Caen, France
- Normandy University, UNICAEN, CEA, CNRS, ISTCT Unit, GIP CYCERON, F-14000 Caen, France
- Correspondence:
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Sharma S, Satapathy A, Aggarwal A, Dewan A, Jain E, Katara R, Kumar V, Pal R, Pandey S, Naidu MM, Kini L, Pradhan D, Mohanty SK. Comparison of epidermal growth factor receptor mutation detection turnaround times and concordance among real-time polymerase chain reaction, high-throughput next-generation sequencing and the Biocartis Idylla™ platforms in non-small cell lung carcinomas. Pathol Res Pract 2021; 220:153394. [PMID: 33706124 DOI: 10.1016/j.prp.2021.153394] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 02/17/2021] [Accepted: 02/21/2021] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Activating mutations in the tyrosine kinase domain of the epidermal growth factor receptor (EGFR) gene of non-small cell lung carcinomas (NSCLC) can be targeted by the tyrosine kinase inhibitors. A number of molecular diagnostic platforms are used to detect actionable targets in the exon(s) 18, 19, 20, and 21 of the EGFR gene. The Idylla™ system (Biocartis, Mechelen, Belgium) is a relatively novel technique and is unique in integrating both sample processing and real-time polymerase chain reaction (RT-PCR) in a single cartridge. We sought to conduct this study to compare the turnaround time (TAT) and concordance of Idylla™ system with the conventional RT-PCR and next-generation sequencing (NGS) for EGFR mutation detection. METHODS In this retrospective analysis, 38 formalin-fixed, paraffin-embedded NSCLC tissue blocks with known NGS results by Ion Torrent™ S5 NGS platform were retested by the RT-PCR and Idylla™ platforms. RESULTS A total of 15 of 38 (39.4 %) tumors that showed various EGFR mutations by NGS and conventional RT-PCR techniques were subjected to the Idylla™testing. These cases satisfied the specimen adequacy criteria of at least 10 % tumor cells for the testing. The mutations detected by the NGS were also detected by the Idylla™ testing. However, NGS identified additional 3 mutations in 3 cases, involving T709 V (exon 18, n = 1) and V774 M (exon 20, n = 2). The tumors with wild type EGFR on NGS did not have any actionable mutation detected by the Idylla™. Average EGFR testing TAT by Idylla™ was only 7.2 h (4-12 hours), as compared to conventional RT-PCR taking 54 h (31-79 hours) and NGS requiring 10.7 days (7.1-14 days). The actual procedure time by conventional RT-PCR was 24 h, NGS was 6.5 days, and Idylla™ was only 3 h. CONCLUSIONS In summary, the Idylla™EGFR testing is an efficient, rapid, and fairly simple tool that can be used in the routine molecular laboratory with limited expertise and infrastructure and using the lowest amount of tissue material.
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Affiliation(s)
- Shivani Sharma
- Department of Pathology and Laboratory Medicine, CORE Diagnostics, Gurgaon, Haryana, India
| | - Abhishek Satapathy
- Department of Pathology and Laboratory Medicine, Advanced Medical Research Institute, Bhubaneswar, Odisha, India
| | - Aditi Aggarwal
- Department of Pathology and Laboratory Medicine, CORE Diagnostics, Gurgaon, Haryana, India
| | - Aditi Dewan
- Department of Pathology and Laboratory Medicine, CORE Diagnostics, Gurgaon, Haryana, India
| | - Ekta Jain
- Department of Pathology and Laboratory Medicine, CORE Diagnostics, Gurgaon, Haryana, India
| | - Rahul Katara
- Department of Pathology and Laboratory Medicine, CORE Diagnostics, Gurgaon, Haryana, India
| | - Vipin Kumar
- Department of Pathology and Laboratory Medicine, CORE Diagnostics, Gurgaon, Haryana, India
| | - Rajan Pal
- Department of Pathology and Laboratory Medicine, CORE Diagnostics, Gurgaon, Haryana, India
| | - Santosh Pandey
- Department of Pathology and Laboratory Medicine, CORE Diagnostics, Gurgaon, Haryana, India
| | - Machita M Naidu
- Department of Pathology and Laboratory Medicine, Advanced Medical Research Institute, Bhubaneswar, Odisha, India
| | - Lata Kini
- Department of Pathology and Laboratory Medicine, CORE Diagnostics, Gurgaon, Haryana, India
| | | | - Sambit K Mohanty
- Department of Pathology and Laboratory Medicine, CORE Diagnostics, Gurgaon, Haryana, India; Department of Pathology and Laboratory Medicine, Advanced Medical Research Institute, Bhubaneswar, Odisha, India.
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7
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Lee E, Jones V, Topkas E, Harraway J. Reduced sensitivity for EGFR T790M mutations using the Idylla EGFR Mutation Test. J Clin Pathol 2020; 74:43-47. [PMID: 32467321 DOI: 10.1136/jclinpath-2020-206527] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 04/11/2020] [Accepted: 04/28/2020] [Indexed: 12/18/2022]
Abstract
AIMS Osimertinib is a third-generation EGFR (epidermal growth factor receptor) tyrosine kinase inhibitor that is effective in non-small cell lung cancer (NSCLC) harbouring the EGFR T790M mutation. The Idylla EGFR Mutation Test is a rapid cartridge-based method for detecting T790M and other EGFR mutations. However, false negative T790M results have been reported, and the sensitivity of the assay for this mutation is uncertain. METHODS Eighty NSCLC samples were tested by both Idylla and a next-generation sequencing (NGS) assay; 46 were from patients at disease progression, and 24 of these had known T790M mutations. Droplet digital PCR (ddPCR) was used to confirm NGS findings in samples with the T790M mutation. RESULTS Of 19 samples with T790M variant allele frequencies (VAF) higher than the stated 5% limit of detection, 14 were detected by Idylla (sensitivity 74%, 95% CI 49% to 90%). Where sufficient sample remained, ddPCR was consistent with NGS findings in all samples. False negative T790M results were associated with higher EGFR control Cq values (median 22.8 vs 19.8), presence of the EGFR Q787Q polymorphism in cis (80% vs 44%) and presence of an invalid T790M amplification curve. An EGFR exon 19 indel with VAF >5% was also not detected by the Idylla assay in two samples. CONCLUSIONS The Idylla EGFR Mutation Test has reduced sensitivity for the T790M mutation compared with NGS and ddPCR methods. The presence of an invalid T790M amplification curve may indicate a possible false negative result that warrants further testing by an orthogonal method.
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Affiliation(s)
- Eric Lee
- Molecular Pathology, Sullivan Nicolaides Pathology, Brisbane, QLD, Australia
| | - Victoria Jones
- Molecular Pathology, Sullivan Nicolaides Pathology, Brisbane, QLD, Australia
| | - Eleni Topkas
- Molecular Pathology, Sullivan Nicolaides Pathology, Brisbane, QLD, Australia
| | - James Harraway
- Molecular Pathology, Sullivan Nicolaides Pathology, Brisbane, QLD, Australia
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Thomas de Montpréville V, Lacroix L, Rouleau E, Mamodaly M, Leclerc J, Tutuianu L, Planchard D, Boulate D, Mercier O, Besse B, Fadel É, Ghigna MR. Non-small cell lung carcinomas with CTNNB1 (beta-catenin) mutations: A clinicopathological study of 26 cases. Ann Diagn Pathol 2020; 46:151522. [PMID: 32442860 DOI: 10.1016/j.anndiagpath.2020.151522] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 03/24/2020] [Indexed: 12/18/2022]
Abstract
Beta-catenin, encoded by the CTNNB1 gene, plays an important role in cell proliferation. Mutations of CTNNB1 are oncogenic in several tumor types and are often associated with a nuclear abnormal expression. However, such mutations have only rarely been reported in non-small cell lung carcinomas and their clinical signification is not well described. Our study was conducted on 26 CTNNB1-mutated non-small cell lung carcinomas. Tumors were routinely tested by next generation sequencing for mutations in exon 3 of CTNNB1 gene. Twenty three cases were from a series of 925 tumors (2.48%). The hospital files and pathological data, from surgical samples (n = 16), small biopsies (n = 5) and trans-bronchial fine needle aspirations (n = 5), were reviewed. Immunohistochemistry was performed with an anti-beta-catenin antibody. There were 10 female and 16 male patients aged 52 to 83. Eleven of 25 patients were no-smoking or light smokers. Three cases were diagnosed while under treatment with EGFR tyrosine kinase inhibitor. There were 25 adenocarcinomas and 1 squamous cell carcinoma. Most adenocarcinomas had a papillary component and were TTF1-positive. One case was a well-differentiated fetal adenocarcinoma. Eleven cases (42%) with CTNNB1 mutations showed associated EGFR mutations. The frequency of CTNNB1 mutations was higher among EGFR mutated carcinomas. Immunohistochemistry showed heterogeneous nuclear or cytoplasmic abnormal expression. Our study shows that CTNNB1 mutations mostly occur in TTF1-positive adenocarcinomas with a papillary pattern. These mutations are often associated with EGFR mutations and possibly interfer in the mechanism of resistance to tyrosine kinase inhibitors. Our experience suggests that immuno-histochemistry cannot be used for screening.
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Affiliation(s)
| | - Ludovic Lacroix
- Department of Pathology and Medical Biology, Gustave Roussy University Hospital, 114 rue Edouard Vaillant, 94805 Villejuif, France
| | - Etienne Rouleau
- Department of Pathology and Medical Biology, Gustave Roussy University Hospital, 114 rue Edouard Vaillant, 94805 Villejuif, France
| | - Maria Mamodaly
- Department of Pathology, Marie Lannelongue Hospital, 133 avenue de la Résistance, 92350 Le Plessis Robinson, France
| | - Julie Leclerc
- Department of Pathology, Marie Lannelongue Hospital, 133 avenue de la Résistance, 92350 Le Plessis Robinson, France
| | - Loredana Tutuianu
- Department of Pathology, Marie Lannelongue Hospital, 133 avenue de la Résistance, 92350 Le Plessis Robinson, France
| | - David Planchard
- Department of Medical Oncology, Gustave Roussy University Hospital, 114 rue Edouard Vaillant, 94805 Villejuif, France
| | - David Boulate
- Department of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Marie Lannelongue Hospital, 133 avenue de la Résistance, 92350 Le Plessis Robinson, France
| | - Olaf Mercier
- Department of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Marie Lannelongue Hospital, 133 avenue de la Résistance, 92350 Le Plessis Robinson, France
| | - Benjamin Besse
- Department of Medical Oncology, Gustave Roussy University Hospital, 114 rue Edouard Vaillant, 94805 Villejuif, France
| | - Élie Fadel
- Department of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Marie Lannelongue Hospital, 133 avenue de la Résistance, 92350 Le Plessis Robinson, France
| | - Maria-Rosa Ghigna
- Department of Pathology, Marie Lannelongue Hospital, 133 avenue de la Résistance, 92350 Le Plessis Robinson, France
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Al-Turkmani MR, Suriawinata MA, Deharvengt SJ, Green DC, Black CC, Shirai K, Dragnev KH, Tsongalis GJ. Rapid EGFR mutation testing in lung cancer tissue samples using a fully automated system and single-use cartridge. Pract Lab Med 2020; 20:e00156. [PMID: 32181314 PMCID: PMC7062922 DOI: 10.1016/j.plabm.2020.e00156] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 02/17/2020] [Accepted: 02/21/2020] [Indexed: 01/10/2023] Open
Abstract
Introduction Activating mutations in the tyrosine kinase domain of the epidermal growth factor receptor (EGFR) gene in non-small cell lung cancer (NSCLC) patients predicts response to EGFR tyrosine kinase inhibitors (TKIs). The Idylla™ system (Biocartis, Mechelen, Belgium) is a fully integrated, cartridge-based platform that provides automated sample processing and real-time PCR-based mutation detection in a single-use cartridge. This study evaluated the Idylla™ EGFR Mutation Assay cartridges against next-generation sequencing (NGS) using formalin fixed, paraffin embedded (FFPE) lung cancer tissue samples. Methods Thirty-four FFPE lung adenocarcinoma tissue samples were tested on the Idylla™ system. 21 had at least one mutation in EGFR and 13 had no EGFR mutation as determined by NGS analysis using the Ion AmpliSeq 50-gene Cancer Hotspot Panel v2 (Thermo Fisher Scientific). One 10 μm FFPE tissue section was used for each Idylla™ test and all cases met the Idylla™ minimum tumor content requirement (≥10%). Results Idylla™ results were in complete agreement with those obtained by NGS for EGFR mutations targeted by the Idylla™. NGS identified two additional EGFR mutations that are not targeted by the Idylla™ in two samples (E709V and V774M). No EGFR mutations were detected by the Idylla™ in samples determined by NGS as having wild-type EGFR. Conclusion The fully automated Idylla™ system offers rapid and reliable testing for clinically actionable mutations in EGFR directly from FFPE tissue sections. Its simplicity and ease of use compared to other available molecular techniques make it suitable for routine clinical use in a variety of settings.
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Affiliation(s)
- M Rabie Al-Turkmani
- Dartmouth-Hitchcock Medical Center and Geisel School of Medicine at Dartmouth. Lebanon, NH, USA
| | - Michael A Suriawinata
- Dartmouth-Hitchcock Medical Center and Geisel School of Medicine at Dartmouth. Lebanon, NH, USA
| | - Sophie J Deharvengt
- Dartmouth-Hitchcock Medical Center and Geisel School of Medicine at Dartmouth. Lebanon, NH, USA
| | - Donald C Green
- Dartmouth-Hitchcock Medical Center and Geisel School of Medicine at Dartmouth. Lebanon, NH, USA
| | - Candice C Black
- Dartmouth-Hitchcock Medical Center and Geisel School of Medicine at Dartmouth. Lebanon, NH, USA
| | - Keisuke Shirai
- Dartmouth-Hitchcock Medical Center and Geisel School of Medicine at Dartmouth. Lebanon, NH, USA
| | - Konstantin H Dragnev
- Dartmouth-Hitchcock Medical Center and Geisel School of Medicine at Dartmouth. Lebanon, NH, USA
| | - Gregory J Tsongalis
- Dartmouth-Hitchcock Medical Center and Geisel School of Medicine at Dartmouth. Lebanon, NH, USA
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Van Haele M, Vander Borght S, Ceulemans A, Wieërs M, Metsu S, Sagaert X, Weynand B. Rapid clinical mutational testing of KRAS, BRAF and EGFR: a prospective comparative analysis of the Idylla technique with high-throughput next-generation sequencing. J Clin Pathol 2019; 73:35-41. [PMID: 31296605 DOI: 10.1136/jclinpath-2019-205970] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 06/24/2019] [Accepted: 06/25/2019] [Indexed: 12/22/2022]
Abstract
AIMS Precision medicine therapy is remodelling the diagnostic landscape of cancer. The success of these new therapies is often based on the presence or absence of a specific mutation in a tumour. The Idylla platform is designed to determine the mutational status of a tumour as quickly and accurately as possible, as a rapid, accurate diagnosis is of the utmost importance for the treatment of patients. This is the first complete prospective study to investigate the robustness of the Idylla platform for EGFR, KRAS and BRAF mutations in non-small cell lung cancer, metastatic colorectal cancer and metastatic melanoma, respectively. METHODS We compared prospectively the Idylla platform with the results we obtained from parallel high-throughput next-generation sequencing, which is the current gold standard for mutational testing. Furthermore, we evaluated the benefits and disadvantages of the Idylla platform in clinical practice. Additionally, we reviewed all the published Idylla performance articles. RESULTS There was an overall agreement of 100%, 94% and 94% between the next-generation panel and the Idylla BRAF, KRAS and EGFR mutation test. Two interesting discordant findings among 48 cases were observed and will be discussed together with the advantages and shortcoming of both techniques. CONCLUSION Our observations demonstrate that the Idylla cartridge for the EGFR, KRAS and BRAF mutations is highly accurate, rapid and has a limited hands-on time compared with next-generation sequencing.
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Affiliation(s)
- Matthias Van Haele
- Department of Imaging and Pathology, KU Leuven, Leuven, Belgium .,Pathology, University Hospitals Leuven, Leuven, Belgium
| | | | - An Ceulemans
- Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | - Michiel Wieërs
- Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | | | - Xavier Sagaert
- Department of Imaging and Pathology, KU Leuven, Leuven, Belgium.,Pathology, University Hospitals Leuven, Leuven, Belgium
| | - Birgit Weynand
- Department of Imaging and Pathology, KU Leuven, Leuven, Belgium.,Pathology, University Hospitals Leuven, Leuven, Belgium
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Fully automated real-time PCR for EGFR testing in non-small cell lung carcinoma. Virchows Arch 2018; 474:187-192. [PMID: 30470932 PMCID: PMC6349793 DOI: 10.1007/s00428-018-2486-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 10/23/2018] [Accepted: 11/13/2018] [Indexed: 01/08/2023]
Abstract
Molecular testing for mutations in the EGFR gene is commonplace for patients with non-small cell lung cancer (NSCLC). These patients are often very sick and management decisions need to be made urgently. In many cases, the results of molecular testing are needed the same day, in order to start targeted therapy and allow maximum benefit for patients. The Idylla™ EGFR Mutation Test offers rapid results within three hours of requesting. This study aimed to assess the concordance of Idylla™ EGFR Mutation Test results with current standard tests. Forty formalin-fixed, paraffin-embedded NSCLC tumour cases (20 EGFR mutant and EGFR 20 wild type) were analysed by the Idylla™ EGFR Mutation Test (CE-IVD) and compared with PCR and NGS methodologies. The overall concordance between Idylla™ and standard testing was 92.5% (95% CI 80.14% to 97.42%) and the specificity of Idylla™ was 100% (95% CI 83.89% to 100%). The sensitivity was affected by loss of tumour content in tissue blocks in a small number of NGS cases; however, comparing Idylla™ with PCR alone, there was 100% concordance (95% CI 89.85% to 100%). The Idylla™ EGFR Mutation Test shows comparative accuracy to routine PCR testing for the most common EGFR mutations in NSCLC. The Idylla™ also offers significantly reduced turn-around times compared with existing modalities and therefore the platform would be a useful addition to many molecular diagnostics units.
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12
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Ghigna MR, Crutu A, Florea V, Feuillet-Soummer S, Baldeyrou P, Adam J, Lacroix L, Besse B, Mercier O, Fadel E, Dorfmuller P, El Ayoubi R, Thomas de Montpréville V. Endobronchial ultrasound-guided fine-needle aspiration for pulmonary carcinomas genotyping: experience with 398 cases including rapid EGFR/KRAS analysis in 43 cases. J Thorac Dis 2018; 10:4653-4658. [PMID: 30174918 PMCID: PMC6105967 DOI: 10.21037/jtd.2018.06.157] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Accepted: 05/28/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND Endobronchial ultrasound-guided fine-needle aspiration (EBUS-FNA) of mediastinal lymph nodes is a minimally invasive and efficient tool for both diagnosis and staging of lung cancer. EBUS-FNA also permits tumor genotyping. However this critical datum for the therapeutic management is often long to obtain for metastatic patients with short life expectancy. METHODS From May 2011 to December 2017, 398 lung cancer patients underwent a genetic analysis based on EBUS-FNA samples. EBUS-FNAs were performed with rapid on-site evaluation. Mutations were studied with Sanger or new generation sequencing. Forty-three cases were also tested with a fully automated real-time PCR rapid technique. ALK abnormalities were assessed by immunohistochemistry and/or in situ hybridization. RESULTS A genotypic result could be obtained in 316 cases (79.4%) and in 180 of the 198 more recent cases (90.9%). Genetic abnormalities were observed in 191 cases (48.0%). Using the rapid technique, EGFR/KRAS mutational status was obtained within a few hours following the histological diagnosis and on the same day of the EBUS-FNA by analyzing fresh specimens after intra-operative cytological diagnosis. CONCLUSIONS In term of molecular diagnosis, EBUS-FNA provides high-quality biological material similar to that of other clinical sampling methods. Furthermore, our study suggests that a rapid molecular diagnostic method could lead to a prompt and appropriate therapeutic management for many advanced stage patients.
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Affiliation(s)
- Maria-Rosa Ghigna
- Department of Pathology, Marie Lannelongue Hospital, Le Plessis Robinson, France
| | - Adrian Crutu
- Department of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Marie Lannelongue Hospital, Le Plessis Robinson, France
| | - Valentina Florea
- Department of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Marie Lannelongue Hospital, Le Plessis Robinson, France
| | - Séverine Feuillet-Soummer
- Department of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Marie Lannelongue Hospital, Le Plessis Robinson, France
| | - Pierre Baldeyrou
- Department of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Marie Lannelongue Hospital, Le Plessis Robinson, France
| | - Julien Adam
- Department of Pathology and Medical Biology, Gustave Roussy University Hospital, Villejuif, France
| | - Ludovic Lacroix
- Department of Pathology and Medical Biology, Gustave Roussy University Hospital, Villejuif, France
| | - Benjamin Besse
- Department of Medical Oncology, Gustave Roussy University Hospital, Villejuif, France
| | - Olaf Mercier
- Department of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Marie Lannelongue Hospital, Le Plessis Robinson, France
| | - Elie Fadel
- Department of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Marie Lannelongue Hospital, Le Plessis Robinson, France
| | - Peter Dorfmuller
- Department of Pathology, Marie Lannelongue Hospital, Le Plessis Robinson, France
| | - Rida El Ayoubi
- Department of Pathology, Marie Lannelongue Hospital, Le Plessis Robinson, France
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13
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Uguen A, Troncone G. A review on the Idylla platform: towards the assessment of actionable genomic alterations in one day. J Clin Pathol 2018; 71:757-762. [DOI: 10.1136/jclinpath-2018-205189] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 05/18/2018] [Accepted: 05/22/2018] [Indexed: 12/27/2022]
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14
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Lambros L, Uguen A. Toward a Molecular Diagnosis in a Single Day for Patients With Advanced Non-small-cell Lung Cancer. Clin Lung Cancer 2018; 19:e537-e538. [PMID: 29801704 DOI: 10.1016/j.cllc.2018.03.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 03/06/2018] [Indexed: 12/12/2022]
Affiliation(s)
| | - Arnaud Uguen
- CHRU Brest, Department of Pathology, Brest, France; Inserm U1053 BaRITOn, Bordeaux, France.
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15
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Ghigna MR, Thomas De Montpréville V. Molecular mechanisms of pathological tumor transformation and their clinical implications: predictors of pulmonary adenocarcinoma transformation into small cell carcinoma. J Thorac Dis 2017; 9:3469-3472. [PMID: 29268318 DOI: 10.21037/jtd.2017.09.15] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- Maria-Rosa Ghigna
- Department of Pathology, Marie Lannelongue Hospital, Le Plessis Robinson, France
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Dorfmüller P, Cavazza A. Lung pathology for the clinician: a comprehensive approach. Eur Respir Rev 2017; 26:26/144/170041. [PMID: 28659505 DOI: 10.1183/16000617.0041-2017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 04/29/2017] [Indexed: 11/05/2022] Open
Affiliation(s)
- Peter Dorfmüller
- Dept of Pathology, Hôpital Marie Lannelongue, Le Plessis Robinson, France
| | - Alberto Cavazza
- Pathology Unit, Arcispedale S. Maria Nuova/IRCCS, Reggio Emilia, Italy
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