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Scarpino S, Leone A, Galafate D, Pepe F, Malapelle U, Villani S, Giarnieri E, Maurizi G, De Vitis C, Mancini R, Mancini M, Di Napoli A, Vecchione A, Pilozzi E. Integrating the Idylla™ System Alongside a Real-Time Polymerase Chain Reaction and Next-Generation Sequencing for Investigating Gene Fusions in Pleural Effusions from Non-Small-Cell Lung Cancer Patients: A Pilot Study. Int J Mol Sci 2024; 25:7594. [PMID: 39062837 PMCID: PMC11277451 DOI: 10.3390/ijms25147594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Revised: 07/04/2024] [Accepted: 07/09/2024] [Indexed: 07/28/2024] Open
Abstract
Malignant pleural effusion (MPE) from patients with advanced non-small-cell lung cancer (NSCLC) has been proven valuable for molecular analysis; however, simultaneous detection of driver fusions in MPE is still challenging. In this study, we investigated the Idylla™ GeneFusion Panel, a stand-alone test in tissue samples, in the evaluation of ALK, ROS1, RET and MET ex14 skipping mutations in MPE and compared its performance with routine reference methods (Real-time-based and Next-generation Sequencing-NGS). The inclusion criteria for sample selection were as follows: advanced NSCLC harboring ALK, ROS1, RET fusions or MET exon-skipping alterations and the availability of MPE collected at diagnosis or disease progression. Molecular alterations have been investigated on tissue by fluorescence in situ hybridization (FISH) or Real-time PCR or NGS. For molecular profiling with the Idylla™ GeneFusion, 200 µL of MPE supernatants combined with 50 µL of RNA Later solution were loaded into the Idylla™ cartridge without cfRNA extraction. The Idylla™ GeneFusion Assay performed on MPEs was able to confirm molecular profile, previously diagnosed with conventional methods, in all cases. Our data confirm that MPE are suitable material for investigating fusion alterations. The Idylla™ GeneFusion, although indicated for investigation of tissue samples, offers the possibility of performing a molecular characterization of supernatants without undertaking the entire cfRNA extraction procedure providing a rapid and reliable strategy for the detection of actionable genetic alterations.
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Affiliation(s)
- Stefania Scarpino
- Department of Clinical and Molecular Medicine, Morphologic and Molecular Pathology Unit, St. Andrea University Hospital, Sapienza University of Rome, 00189 Rome, Italy; (D.G.); (S.V.); (E.G.); (C.D.V.); (R.M.); (M.M.); (A.D.N.); (A.V.); (E.P.)
| | - Alvaro Leone
- Anatomic Pathology Unit, San Camillo-Forlanini Hospitals, 00152 Rome, Italy;
| | - Dino Galafate
- Department of Clinical and Molecular Medicine, Morphologic and Molecular Pathology Unit, St. Andrea University Hospital, Sapienza University of Rome, 00189 Rome, Italy; (D.G.); (S.V.); (E.G.); (C.D.V.); (R.M.); (M.M.); (A.D.N.); (A.V.); (E.P.)
| | - Francesco Pepe
- Department of Public Health, University of Naples Federico II, 80138 Naples, Italy; (F.P.); (U.M.)
| | - Umberto Malapelle
- Department of Public Health, University of Naples Federico II, 80138 Naples, Italy; (F.P.); (U.M.)
| | - Sandra Villani
- Department of Clinical and Molecular Medicine, Morphologic and Molecular Pathology Unit, St. Andrea University Hospital, Sapienza University of Rome, 00189 Rome, Italy; (D.G.); (S.V.); (E.G.); (C.D.V.); (R.M.); (M.M.); (A.D.N.); (A.V.); (E.P.)
| | - Enrico Giarnieri
- Department of Clinical and Molecular Medicine, Morphologic and Molecular Pathology Unit, St. Andrea University Hospital, Sapienza University of Rome, 00189 Rome, Italy; (D.G.); (S.V.); (E.G.); (C.D.V.); (R.M.); (M.M.); (A.D.N.); (A.V.); (E.P.)
| | - Giulio Maurizi
- Department of Thoracic Surgery, Sant’ Andrea Hospital, Sapienza University of Rome, 00189 Rome, Italy;
| | - Claudia De Vitis
- Department of Clinical and Molecular Medicine, Morphologic and Molecular Pathology Unit, St. Andrea University Hospital, Sapienza University of Rome, 00189 Rome, Italy; (D.G.); (S.V.); (E.G.); (C.D.V.); (R.M.); (M.M.); (A.D.N.); (A.V.); (E.P.)
| | - Rita Mancini
- Department of Clinical and Molecular Medicine, Morphologic and Molecular Pathology Unit, St. Andrea University Hospital, Sapienza University of Rome, 00189 Rome, Italy; (D.G.); (S.V.); (E.G.); (C.D.V.); (R.M.); (M.M.); (A.D.N.); (A.V.); (E.P.)
| | - Massimiliano Mancini
- Department of Clinical and Molecular Medicine, Morphologic and Molecular Pathology Unit, St. Andrea University Hospital, Sapienza University of Rome, 00189 Rome, Italy; (D.G.); (S.V.); (E.G.); (C.D.V.); (R.M.); (M.M.); (A.D.N.); (A.V.); (E.P.)
| | - Arianna Di Napoli
- Department of Clinical and Molecular Medicine, Morphologic and Molecular Pathology Unit, St. Andrea University Hospital, Sapienza University of Rome, 00189 Rome, Italy; (D.G.); (S.V.); (E.G.); (C.D.V.); (R.M.); (M.M.); (A.D.N.); (A.V.); (E.P.)
| | - Andrea Vecchione
- Department of Clinical and Molecular Medicine, Morphologic and Molecular Pathology Unit, St. Andrea University Hospital, Sapienza University of Rome, 00189 Rome, Italy; (D.G.); (S.V.); (E.G.); (C.D.V.); (R.M.); (M.M.); (A.D.N.); (A.V.); (E.P.)
| | - Emanuela Pilozzi
- Department of Clinical and Molecular Medicine, Morphologic and Molecular Pathology Unit, St. Andrea University Hospital, Sapienza University of Rome, 00189 Rome, Italy; (D.G.); (S.V.); (E.G.); (C.D.V.); (R.M.); (M.M.); (A.D.N.); (A.V.); (E.P.)
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Frampton JE. Osimertinib: A Review in Completely Resected, Early-Stage, EGFR Mutation-Positive NSCLC. Target Oncol 2022; 17:369-376. [PMID: 35713772 DOI: 10.1007/s11523-022-00883-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2022] [Indexed: 11/25/2022]
Abstract
Osimertinib (TAGRISSO®) is an orally administered, third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor that is approved for the adjuvant treatment of adults with completely resected, stage IB-IIIA, EGFR sensitizing mutation (exon 19 deletion or exon 21 [L858R] substitution)-positive non-small cell lung cancer (NSCLC). In the pivotal ADAURA trial in adults with completely resected, early-stage, EGFR mutation-positive (EGFRm+) NSCLC, osimertinib adjuvant therapy significantly prolonged disease-free survival (DFS) compared with placebo in the overall population of patients with stage IB-IIIA disease, as well as in the primary population of patients with stage II-IIIA disease. A DFS benefit of osimertinib was seen irrespective of whether or not patients received prior adjuvant chemotherapy. Overall survival (OS) data were very immature at the time of the analysis of DFS, and more mature OS data are awaited with interest. Osimertinib adjuvant therapy did not adversely affect health-related quality of life and was generally well tolerated, with a manageable safety profile and no new safety signals identified. Based on the available evidence, osimertinib is thus an appropriate targeted option for the adjuvant treatment of adults with completely resected, stage IB-IIIA, EGFRm+ NSCLC.
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Affiliation(s)
- James E Frampton
- Springer Nature, Mairangi Bay, Private Bag 65901, Auckland, 0754, New Zealand.
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