1
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Mok T. Reply to D.-C. Mo et al. J Clin Oncol 2024; 42:2617-2618. [PMID: 38754075 DOI: 10.1200/jco.24.00629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 03/28/2024] [Indexed: 05/18/2024] Open
Affiliation(s)
- Tony Mok
- Tony Mok, MD, FRCPC, FASCO, State Laboratory of Translational Oncology, The Chinese University of Hong Kong, Hong Kong, China
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2
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Wang Y, Zhang Y, Ren N, Li F, Lu L, Zhao X, Zhou Z, Gao M, Wang M. Repeat biopsy versus initial biopsy in terms of complication risk factors and clinical outcomes for patients with non-small cell lung cancer: a comparative study of 113 CT-guided needle biopsy of lung lesions. Front Oncol 2024; 14:1367603. [PMID: 38803532 PMCID: PMC11129557 DOI: 10.3389/fonc.2024.1367603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 04/17/2024] [Indexed: 05/29/2024] Open
Abstract
Objectives The safety and feasibility of repeat biopsy after systemic treatment for non-small cell lung cancer have received extensive attention in recent years. The purpose of this research was to compare complication rates between initial biopsy and rebiopsy in non-small cell lung cancer patients with progressive disease and to assess complication risk factors and clinical results after rebiopsy. Methods The study included 113 patients initially diagnosed with non-small cell lung cancer who underwent lung biopsy at initial biopsy and rebiopsy after progression while on epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) and/or chemotherapy from January 2018 to December 2021. We compared the incidence of complications between the initial biopsy and rebiopsy and analyzed the predictors factors that influenced complications in patients who underwent rebiopsy. Results The successful rate of rebiopsy was 88.5% (100/113). With the exception of two cases where lung adenocarcinoma changed into small cell lung cancer with gefitinib treatment, 98 individuals retained their initial pathological type. The secondary EGFR T790M mutation accounts for 55.6% of acquired resistance. The total number of patients with complications in initial biopsy was 25 (22.1%) and 37 (32.7%) in the rebiopsy. The incidence of pulmonary hemorrhage increased from 7.1% at the initial biopsy to 10.6% at rebiopsy, while the incidence of pneumothorax increased from 14.2% to 20.4%. Compared with the initial biopsy, the incidence of overall complications, parenchymal hemorrhage, and pneumothorax increased by 10.6%, 3.5%, and 6.2%, respectively. In all four evaluations (pneumorrhagia, pneumothorax, pleural reaction, and overall complication), there were no significant differences between the rebiopsy and initial biopsy (all p > 0.05). The multivariate logistic regression analysis suggested that male sex (odds ratio [OR] = 5.064, p = 0.001), tumor size ≤ 2 cm (OR = 3.367, p = 0.013), EGFR-TKIs with chemotherapy (OR = 3.633, p =0.023), and transfissural approach (OR = 7.583, p = 0.026) were independent risk factors for overall complication after rebiopsy. Conclusion Compared with the initial biopsy, the complication rates displayed a slight, but not significant, elevation in rebiopsy. Male sex, tumor size ≤ 2 cm, transfissural approach, and EGFR-TKIs combined with chemotherapy were independent risk factors for rebiopsy complications.
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Affiliation(s)
- Yangyang Wang
- Department of Medical Imaging, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yongyuan Zhang
- Department of Medical Imaging, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Nana Ren
- Department of Medical Imaging, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Fangting Li
- Department of Medical Imaging, Zhengzhou People’s Hospital, Zhengzhou, China
| | - Lin Lu
- Department of Medical Imaging, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xin Zhao
- Department of Medical Imaging, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zhigang Zhou
- Department of Medical Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Mengyu Gao
- Department of Medical Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Meng Wang
- Department of Medical Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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3
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Zheng X, Wu Y, Zuo H, Chen W, Wang K. Metal Nanoparticles as Novel Agents for Lung Cancer Diagnosis and Therapy. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2023; 19:e2206624. [PMID: 36732908 DOI: 10.1002/smll.202206624] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 12/31/2022] [Indexed: 05/04/2023]
Abstract
Lung cancer is one of the most common malignancies worldwide and contributes to most cancer-related morbidity and mortality cases. During the past decades, the rapid development of nanotechnology has provided opportunities and challenges for lung cancer diagnosis and therapeutics. As one of the most extensively studied nanostructures, metal nanoparticles obtain higher satisfaction in biomedical applications associated with lung cancer. Metal nanoparticles have enhanced almost all major imaging strategies and proved great potential as sensor for detecting cancer-specific biomarkers. Moreover, metal nanoparticles could also improve therapeutic efficiency via better drug delivery, improved radiotherapy, enhanced gene silencing, and facilitated photo-driven treatment. Herein, the recently advanced metal nanoparticles applied in lung cancer therapy and diagnosis are summarized. Future perspective on the direction of metal-based nanomedicine is also discussed. Stimulating more research interests to promote the development of metal nanoparticles in lung cancer is devoted.
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Affiliation(s)
- Xinjie Zheng
- Department of Respiratory Medicine, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, 322000, China
| | - Yuan Wu
- Department of Respiratory Medicine, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, 322000, China
| | - Huali Zuo
- Department of Respiratory Medicine, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, 322000, China
| | - Weiyu Chen
- Department of Respiratory Medicine, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, 322000, China
- International Institutes of Medicine, The Fourth Affiliated Hospital of Zhejiang University School of Medicine, Yiwu, Zhejiang, 322000, China
| | - Kai Wang
- Department of Respiratory Medicine, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, 322000, China
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4
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Nicoś M, Krawczyk P. Genetic Clonality as the Hallmark Driving Evolution of Non-Small Cell Lung Cancer. Cancers (Basel) 2022; 14:1813. [PMID: 35406585 PMCID: PMC8998004 DOI: 10.3390/cancers14071813] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 03/28/2022] [Accepted: 03/29/2022] [Indexed: 12/12/2022] Open
Abstract
Data indicate that many driver alterations from the primary tumor of non-small cell lung cancer (NSCLC) are predominantly shared across all metastases; however, disseminating cells may also acquire a new genetic landscape across their journey. By comparing the constituent subclonal mutations between pairs of primary and metastatic samples, it is possible to derive the ancestral relationships between tumor clones, rather than between tumor samples. Current treatment strategies mostly rely on the theory that metastases are genetically similar to the primary lesions from which they arise. However, intratumor heterogeneity (ITH) affects accurate diagnosis and treatment decisions and it is considered the main hallmark of anticancer therapy failure. Understanding the genetic changes that drive the metastatic process is critical for improving the treatment strategies of this deadly condition. Application of next generation sequencing (NGS) techniques has already created knowledge about tumorigenesis and cancer evolution; however, further NGS implementation may also allow to reconstruct phylogenetic clonal lineages and clonal expansion. In this review, we discuss how the clonality of genetic alterations influence the seeding of primary and metastatic lesions of NSCLC. We highlight that wide genetic analyses may reveal the phylogenetic trajectories of NSCLC evolution, and may pave the way to better management of follow-up and treatment.
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Affiliation(s)
- Marcin Nicoś
- Department of Pneumonology, Oncology and Allergology, Medical University of Lublin, 20-954 Lublin, Poland;
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5
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Liquid Biopsy for Biomarker Testing in Non-Small Cell Lung Cancer: A European Perspective. JOURNAL OF MOLECULAR PATHOLOGY 2021. [DOI: 10.3390/jmp2030022] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
The development of targeted therapies has improved survival rates for patients with advanced non-small cell lung cancer (NSCLC). However, tissue biopsy is unfeasible or inadequate in many patients, limiting biomarker testing and access to targeted therapies. The increasing numbers of established and emerging biomarkers with available targeted treatments highlights the challenges associated with sequential single-gene testing and limited tissue availability. Multiplex next-generation sequencing (NGS) offers an attractive alternative and represents a logical next step, and in cases where the tumour is inaccessible, tissue biopsy yields insufficient tumour content, or when the patient’s performance status does not allow a tissue biopsy, liquid biopsy can provide valuable material for molecular diagnosis. Here, we explore the role of liquid biopsy (i.e., circulating cell-free DNA analysis) in Europe. Liquid biopsies could be used as a complementary approach to increase rates of molecular diagnosis, with the ultimate aim of improving patient access to appropriate targeted therapies. Expert opinion is also provided on potential future applications of liquid biopsy in NSCLC, including for cancer prevention, detection of early stage and minimum residual disease, monitoring of response to therapy, selection of patients for immunotherapy, and monitoring of tumour evolution to enable optimal adaptation/combination of drug therapies.
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6
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Abstract
ABSTRACT Percutaneous computed tomography-guided transthoracic lung biopsy is an effective and minimally invasive procedure to achieve tissue diagnosis. Radiologists are key in appropriate referral for further workup, with percutaneous computed tomography-guided transthoracic lung biopsy performed by both thoracic and general interventionalists. Percutaneous computed tomography-guided transthoracic lung biopsy is increasingly performed for both diagnostic and research purposes, including molecular analysis. Multiple patient, lesion, and technique-related variables influence diagnostic accuracy and complication rates. A comprehensive understanding of these factors aids in procedure planning and may serve to maximize diagnostic yield while minimizing complications, even in the most challenging scenarios.
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7
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Carvalho Â, Ferreira G, Seixas D, Guimarães-Teixeira C, Henrique R, Monteiro FJ, Jerónimo C. Emerging Lab-on-a-Chip Approaches for Liquid Biopsy in Lung Cancer: Status in CTCs and ctDNA Research and Clinical Validation. Cancers (Basel) 2021; 13:cancers13092101. [PMID: 33925308 PMCID: PMC8123575 DOI: 10.3390/cancers13092101] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 04/16/2021] [Accepted: 04/25/2021] [Indexed: 01/31/2023] Open
Abstract
Simple Summary Lung cancer (LCa) remains the leading cause of cancer-related mortality worldwide, with late diagnosis and limited therapeutic approaches still constraining patient’s outcome. In recent years, liquid biopsies have significantly improved the disease characterization and brought new insights into LCa diagnosis and management. The integration of microfluidic devices in liquid biopsies have shown promising results regarding circulating biomarkers isolation and analysis and these tools are expected to establish automatized and standardized results for liquid biopsies in the near future. Herein, we review the status of lab-on-a-chip approaches for liquid biopsies in LCa and highlight their current applications for circulating tumor cells (CTCs) and circulating tumor DNA (ctDNA) research and clinical validation studies. Abstract Despite the intensive efforts dedicated to cancer diagnosis and treatment, lung cancer (LCa) remains the leading cause of cancer-related mortality, worldwide. The poor survival rate among lung cancer patients commonly results from diagnosis at late-stage, limitations in characterizing tumor heterogeneity and the lack of non-invasive tools for detection of residual disease and early recurrence. Henceforth, research on liquid biopsies has been increasingly devoted to overcoming these major limitations and improving management of LCa patients. Liquid biopsy is an emerging field that has evolved significantly in recent years due its minimally invasive nature and potential to assess various disease biomarkers. Several strategies for characterization of circulating tumor cells (CTCs) and circulating tumor DNA (ctDNA) have been developed. With the aim of standardizing diagnostic and follow-up practices, microfluidic devices have been introduced to improve biomarkers isolation efficiency and specificity. Nonetheless, implementation of lab-on-a-chip platforms in clinical practice may face some challenges, considering its recent application to liquid biopsies. In this review, recent advances and strategies for the use of liquid biopsies in LCa management are discussed, focusing on high-throughput microfluidic devices applied for CTCs and ctDNA isolation and detection, current clinical validation studies and potential clinical utility.
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Affiliation(s)
- Ângela Carvalho
- i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Rua Alfredo Allen 208, 4200-135 Porto, Portugal; (G.F.); (D.S.); (F.J.M.)
- INEB-Instituto de Engenharia Biomédica, Universidade do Porto, Rua Alfredo Allen 208, 4200-135 Porto, Portugal
- Porto Comprehensive Cancer Center (P.CCC), R. Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal; (C.G.-T.); (R.H.); (C.J.)
- Correspondence: ; Tel.: +351-226-074-900
| | - Gabriela Ferreira
- i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Rua Alfredo Allen 208, 4200-135 Porto, Portugal; (G.F.); (D.S.); (F.J.M.)
- INEB-Instituto de Engenharia Biomédica, Universidade do Porto, Rua Alfredo Allen 208, 4200-135 Porto, Portugal
- Porto Comprehensive Cancer Center (P.CCC), R. Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal; (C.G.-T.); (R.H.); (C.J.)
| | - Duarte Seixas
- i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Rua Alfredo Allen 208, 4200-135 Porto, Portugal; (G.F.); (D.S.); (F.J.M.)
- INEB-Instituto de Engenharia Biomédica, Universidade do Porto, Rua Alfredo Allen 208, 4200-135 Porto, Portugal
- Porto Comprehensive Cancer Center (P.CCC), R. Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal; (C.G.-T.); (R.H.); (C.J.)
- Cancer Biology and Epigenetics Group, IPO Porto Research Center (GEBC CI-IPOP), Portuguese Oncology Institute of Porto (IPO Porto), R. Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal
| | - Catarina Guimarães-Teixeira
- Porto Comprehensive Cancer Center (P.CCC), R. Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal; (C.G.-T.); (R.H.); (C.J.)
- Cancer Biology and Epigenetics Group, IPO Porto Research Center (GEBC CI-IPOP), Portuguese Oncology Institute of Porto (IPO Porto), R. Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal
| | - Rui Henrique
- Porto Comprehensive Cancer Center (P.CCC), R. Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal; (C.G.-T.); (R.H.); (C.J.)
- Cancer Biology and Epigenetics Group, IPO Porto Research Center (GEBC CI-IPOP), Portuguese Oncology Institute of Porto (IPO Porto), R. Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal
- Department of Pathology, Portuguese Oncology Institute of Porto (IPO Porto), R. Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal
- Department of Pathology and Molecular Immunology, Institute of Biomedical Sciences Abel Salazar, University of Porto (ICBAS-UP), Rua Jorge Viterbo Ferreira 228, 4050-513 Porto, Portugal
| | - Fernando J. Monteiro
- i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Rua Alfredo Allen 208, 4200-135 Porto, Portugal; (G.F.); (D.S.); (F.J.M.)
- INEB-Instituto de Engenharia Biomédica, Universidade do Porto, Rua Alfredo Allen 208, 4200-135 Porto, Portugal
- Porto Comprehensive Cancer Center (P.CCC), R. Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal; (C.G.-T.); (R.H.); (C.J.)
- Faculdade de Engenharia, Departamento de Engenharia Metalúrgica e Materiais, Universidade do Porto, Rua Dr Roberto Frias, s/n, 4200-465 Porto, Portugal
| | - Carmen Jerónimo
- Porto Comprehensive Cancer Center (P.CCC), R. Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal; (C.G.-T.); (R.H.); (C.J.)
- Cancer Biology and Epigenetics Group, IPO Porto Research Center (GEBC CI-IPOP), Portuguese Oncology Institute of Porto (IPO Porto), R. Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal
- Department of Pathology and Molecular Immunology, Institute of Biomedical Sciences Abel Salazar, University of Porto (ICBAS-UP), Rua Jorge Viterbo Ferreira 228, 4050-513 Porto, Portugal
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8
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Nicoś M, Krawczyk P, Crosetto N, Milanowski J. The Role of Intratumor Heterogeneity in the Response of Metastatic Non-Small Cell Lung Cancer to Immune Checkpoint Inhibitors. Front Oncol 2020; 10:569202. [PMID: 33344229 PMCID: PMC7746867 DOI: 10.3389/fonc.2020.569202] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 11/09/2020] [Indexed: 12/12/2022] Open
Abstract
Immune checkpoint inhibitors (ICIs) represent one of the most promising therapeutic approaches in metastatic non-small cell lung cancer (M-NSCLC). Unfortunately, approximately 50–75% of patients do not respond to this treatment modality. Intratumor heterogeneity (ITH) at the genetic and phenotypic level is considered as a major cause of anticancer therapy failure, including resistance to ICIs. Recent observations suggest that spatial heterogeneity in the composition and spatial organization of the tumor microenvironment plays a major role in the response of M-NSCLC patients to ICIs. In this mini review, we first present a brief overview of the use of ICIs in M-NSCLC. We then discuss the role of genetic and non-genetic ITH on the efficacy of ICIs in patients with M-NSCLC.
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Affiliation(s)
- Marcin Nicoś
- Department of Pneumonology, Oncology and Allergology, Medical University of Lublin, Lublin, Poland.,Science for Life Laboratory, Department of Medical Biochemistry and Biophysics, Karolinska Institutet, Stockholm, Sweden
| | - Paweł Krawczyk
- Department of Pneumonology, Oncology and Allergology, Medical University of Lublin, Lublin, Poland
| | - Nicola Crosetto
- Science for Life Laboratory, Department of Medical Biochemistry and Biophysics, Karolinska Institutet, Stockholm, Sweden
| | - Janusz Milanowski
- Department of Pneumonology, Oncology and Allergology, Medical University of Lublin, Lublin, Poland
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9
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Yoon SH, Lee SM, Park CH, Lee JH, Kim H, Chae KJ, Jin KN, Lee KH, Kim JI, Hong JH, Hwang EJ, Kim H, Suh YJ, Park S, Park YS, Kim DW, Choi M, Park CM. 2020 Clinical Practice Guideline for Percutaneous Transthoracic Needle Biopsy of Pulmonary Lesions: A Consensus Statement and Recommendations of the Korean Society of Thoracic Radiology. Korean J Radiol 2020; 22:263-280. [PMID: 33236542 PMCID: PMC7817630 DOI: 10.3348/kjr.2020.0137] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 06/30/2020] [Accepted: 07/02/2020] [Indexed: 02/07/2023] Open
Abstract
Percutaneous transthoracic needle biopsy (PTNB) is one of the essential diagnostic procedures for pulmonary lesions. Its role is increasing in the era of CT screening for lung cancer and precision medicine. The Korean Society of Thoracic Radiology developed the first evidence-based clinical guideline for PTNB in Korea by adapting pre-existing guidelines. The guideline provides 39 recommendations for the following four main domains of 12 key questions: the indications for PTNB, pre-procedural evaluation, procedural technique of PTNB and its accuracy, and management of post-biopsy complications. We hope that these recommendations can improve the diagnostic accuracy and safety of PTNB in clinical practice and promote standardization of the procedure nationwide.
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Affiliation(s)
- Soon Ho Yoon
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Sang Min Lee
- Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Chul Hwan Park
- Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jong Hyuk Lee
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Hyungjin Kim
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Kum Ju Chae
- Department of Radiology, Institute of Medical Science, Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea
| | - Kwang Nam Jin
- Department of Radiology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea
| | - Kyung Hee Lee
- Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Jung Im Kim
- Department of Radiology, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Jung Hee Hong
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Eui Jin Hwang
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Heekyung Kim
- Department of Radiology, Eulji University College of Medicine, Eulji University Hospital, Daejeon, Korea
| | - Young Joo Suh
- Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Samina Park
- Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Young Sik Park
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Dong Wan Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.,Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Miyoung Choi
- National Evidence-based Healthcare Collaborating Agency, Seoul, Korea
| | - Chang Min Park
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.,Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea.
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10
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Gagné A, Orain M, Ionescu D, Tsao MS, Joubert D, Joubert P. Comprehensive assessment of PD-L1 immunohistochemistry on paired tissue and cytology specimens from non-small cell lung cancer. Lung Cancer 2020; 146:276-284. [PMID: 32593917 DOI: 10.1016/j.lungcan.2020.06.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 05/28/2020] [Accepted: 06/01/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES PD-L1 staining assessed by immunohistochemistry (IHC) is a predictive biomarker used to select advanced stage non-small cell lung carcinoma (NSCLC) patients who are likely to respond to PD-1/PD-L1 inhibitors. Cytology specimens represent a significant percentage of the diagnostic samples and additional data are required to show that they provide reliable PD-L1 results when compared to tissue specimens. We aimed to compare PD-L1 staining obtained from patient-matched tissue and cytology specimens. We also want to assess the feasibility of PD-L1 testing on cell blocks with two assays by evaluating the intra- and inter-observer agreement and the level of difficulty for determining the percentage of stained tumor cells (TPS). MATERIALS AND METHODS Forty-six patients with NSCLC were selected. Each patient provided a surgical specimen and a cytology sample (cell block) and/or a biopsy at diagnosis. PD-L1 staining using Agilent PD-L1 IHC 28-8 pharmDx and VENTANA PD-L1 (SP263) assays was evaluated by four pathologists using the TPS. Sixty slides were rescored to document intra-observer agreement. Pathologists were asked to score the level of difficulty for evaluating PD-L1 TPS for each slide. Fleiss's and Cohen's kappas (k) were used to assess the agreement between paired specimens as well as intra- and inter-observer agreement. RESULTS The concordance in PD-L1 TPS between cell blocks and surgical specimens (k varying from 0.56 to 0.82) or biopsies (k from 0.43 to 0.81) was moderate to substantial, depending on the cut-off. On cell blocks, inter-observer agreement was substantial (k from 0.74 to 0.82) and intra-observer agreement was almost perfect (k from 0.85 to 0.93). The perceived difficulty of PD-L1 evaluation of cell blocks was not different from surgical specimens but more difficult than biopsy samples. CONCLUSION PD-L1 TPS was concordant between cell blocks and tissue specimens, mainly at 10, 25 and 50 % cut-offs. PD-L1 evaluation on cell blocks was feasible and reproducible between different observers and assays.
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Affiliation(s)
- Andréanne Gagné
- Institut Universitaire de Cardiologie et de Pneumologie de Québec (Quebec City Heart and Lung Institute) Research Center and Department of Cytology and Pathology, Quebec City, Canada.
| | - Michèle Orain
- Institut Universitaire de Cardiologie et de Pneumologie de Québec (Quebec City Heart and Lung Institute) Research Center and Department of Cytology and Pathology, Quebec City, Canada.
| | - Diana Ionescu
- British Columbia Cancer Agency, Department of Pathology, Vancouver, Canada.
| | - Ming-Sound Tsao
- University Health Network, Princess Margaret Cancer Centre, Department of Pathology, Toronto, Canada.
| | - David Joubert
- University of Ottawa, Faculty of Social Sciences, Ottawa, Canada.
| | - Philippe Joubert
- Institut Universitaire de Cardiologie et de Pneumologie de Québec (Quebec City Heart and Lung Institute) Research Center and Department of Cytology and Pathology, Quebec City, Canada.
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11
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Levy EB, Fiel MI, Hamilton SR, Kleiner DE, McCall SJ, Schirmacher P, Travis W, Kuo MD, Suh RD, Tam AL, Islam SU, Ferry-Galow K, Enos RA, Doroshow JH, Makhlouf HR. State of the Art: Toward Improving Outcomes of Lung and Liver Tumor Biopsies in Clinical Trials-A Multidisciplinary Approach. J Clin Oncol 2020; 38:1633-1640. [PMID: 32134701 DOI: 10.1200/jco.19.02322] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
PURPOSE National Cancer Institute (NCI)-sponsored clinical trial network studies frequently require biopsy specimens for pharmacodynamic and molecular biomarker analyses, including paired pre- and post-treatment samples. The purpose of this meeting of NCI-sponsored investigators was to identify local institutional standard procedures found to ensure quantitative and qualitative specimen adequacy. METHODS NCI convened a conference on best biopsy practices, focusing on the clinical research community. Topics discussed were (1) criteria for specimen adequacy in the personalized medicine era, (2) team-based approaches to ensure specimen adequacy and quality control, and (3) risk considerations relevant to academic and community practitioners and their patients. RESULTS AND RECOMMENDATIONS Key recommendations from the convened consensus panel included (1) establishment of infrastructure for multidisciplinary biopsy teams with a formalized information capture process, (2) maintenance of standard operating procedures with regular team review, (3) optimization of tissue collection and yield methodology, (4) incorporation of needle aspiration and other newer techniques, and (5) commitment of stakeholders to use of guideline documents to increase awareness of best biopsy practices, with the goal of universally improving tumor biopsy practices.
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Affiliation(s)
- Elliot B Levy
- Center for Interventional Oncology, Radiology and Imaging Sciences and Center for Cancer Research, National Institutes of Health, Bethesda, MD
| | - Maria I Fiel
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Stanley R Hamilton
- Pathology and Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - David E Kleiner
- Laboratory of Pathology, National Institutes of Health, Bethesda, MD
| | | | - Peter Schirmacher
- Institute of Pathology, University of Heidelberg, Heidelberg, Germany
| | - William Travis
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Michael D Kuo
- Department of Radiology Medical Artificial Intelligence Laboratory Initiative, The University of Hong Kong, Hong Kong
| | - Robert D Suh
- Department of Radiological Sciences, Ronald Reagan UCLA Medical Center, Los Angeles, CA
| | - Alda L Tam
- Department of Interventional Radiology, MD Anderson Cancer Center, Houston, TX
| | - Shaheen U Islam
- Division of Pulmonary, Critical Care & Sleep Medicine, Medical College of Georgia, Augusta University, Augusta, GA
| | - Katherine Ferry-Galow
- Laboratory of Human Toxicology and Pharmacology, Applied/ Developmental Research Support Directorate, Leidos Biomedical Research, Frederick National Laboratory for Cancer Research, Frederick, MD
| | | | - James H Doroshow
- Division of Cancer Treatment and Diagnosis, National Cancer Institute, Bethesda, MD
| | - Hala R Makhlouf
- Division of Cancer Treatment and Diagnosis, National Cancer Institute, Bethesda, MD
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12
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Bortolotto C, Maglia C, Ciuffreda A, Coretti M, Catania R, Antonacci F, Carnevale S, Sarotto I, Dore R, Filippi AR, Chiara G, Regge D, Preda L, Morbini P, Stella GM. The growth of non-solid neoplastic lung nodules is associated with low PD L1 expression, irrespective of sampling technique. J Transl Med 2020; 18:54. [PMID: 32013991 PMCID: PMC6998829 DOI: 10.1186/s12967-020-02241-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 01/26/2020] [Indexed: 01/05/2023] Open
Abstract
Background Few data are known regarding the molecular features and patterns of growth and presentation which characterize those lung neoplastic lesions presenting as non-solid nodules (NSN). Methods We retrospectively reviewed two different cohorts of NSNs detected by CT scan which, after transthoracic fine-needle aspiration (FNA) and core needle biopsy (CNB) received a final diagnosis of malignancy. All the enrolled patients were then addressed to surgical removal of lung cancer nodules or to exclusive radiotherapy. Exhaustive clinical and radiological features were available for each case. Results In all 62 analysed cases the diagnosis of adenocarcinoma (ADC) was reached. In cytologic samples, EGFR activating mutations were identified in 2 of the 28 cases (7%); no case showed ALK/EML4 or ROS1 translocations. In the histologic samples EGFR activating mutation were found in 4 out of 25 cases (16%). PD-L1 immunostains could be evaluated in 30 cytologic samples, while the remaining 7 did not reach the cellularity threshold for evaluation. TPS was < 1% in 26 cases, > 1% < 50% in 3, and > 50% in 1. All surgical samples showed TPS < 1%. Of the 17 cases that could be evaluated on both samples, 15 were concordantly TPS 0, and 2 showed TPS > 1% < 50 on the biopsy samples. TPS was < 1% in 14 cases, > 1%/< 5% in 4 cases, > 5%/< 50% in 2 cases, > 50% in 1 case. Conclusions Overall PD-L1 immunostaining documented the predominance of low/negative TPS, with high concordance in FNA and corresponding surgical samples. It can be hypothesized that lung ADC with NSN pattern and predominant in situ (i.e. lepidic) components represent the first steps in tumor progression, which have not yet triggered immune response, and/or have not accumulated a significant rate of mutations and neoantigen production, or that they belong to the infiltrated-excluded category of tumors. The negative prediction of response to immunomodulating therapy underlines the importance of rapid surgical treatment of these lesions. Notably, cell block cytology seems to fail in detecting EGFR mutations, thus suggesting that this kind of sampling technique should be not adequate in case of DNA direct sequencing.
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Affiliation(s)
- Chandra Bortolotto
- Department of Intensive Medicine, Unit of Radiology, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, Pavia, Italy
| | - Claudio Maglia
- Radiology Unit, IRCCS Candiolo Cancer Institute and University of Turin Medical School, Candiolo, TO, Italy
| | - Antonio Ciuffreda
- Department of Medical Sciences and Infective Diseases, Unit of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, 27100, Pavia, Italy
| | - Manuela Coretti
- Department of Medical Sciences and Infective Diseases, Unit of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, 27100, Pavia, Italy
| | - Roberta Catania
- Department of Intensive Medicine, Unit of Radiology, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, Pavia, Italy
| | - Filippo Antonacci
- Department of Intensive Medicine, Unit of Cardiothoracic Surgery, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, Pavia, Italy
| | - Sergio Carnevale
- Department of Molecular Medicine, Unit of Pathology, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, Pavia, Italy
| | - Ivana Sarotto
- Unit of Pathology, IRCCS Candiolo Cancer Institute, Candiolo, TO, Italy
| | - Roberto Dore
- Department of Intensive Medicine, Unit of Radiology, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, Pavia, Italy
| | - Andrea Riccardo Filippi
- Department of Medical Sciences and Infective Diseases, Unit of Radiation Therapy, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, Pavia, Italy
| | - Gabriele Chiara
- Radiology Unit, IRCCS Candiolo Cancer Institute and University of Turin Medical School, Candiolo, TO, Italy
| | - Daniele Regge
- Radiology Unit, IRCCS Candiolo Cancer Institute and University of Turin Medical School, Candiolo, TO, Italy
| | - Lorenzo Preda
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Patrizia Morbini
- Department of Molecular Medicine, Unit of Pathology, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, Pavia, Italy
| | - Giulia Maria Stella
- Department of Medical Sciences and Infective Diseases, Unit of Respiratory Diseases, IRCCS Policlinico San Matteo Foundation and University of Pavia Medical School, 27100, Pavia, Italy.
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13
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Gosney JR, Haragan A, Chadwick C, Giles TE, Grundy S, Tippett V, Gumparthy KP, Wight A, Tan HG. Programmed death ligand 1 expression in EBUS aspirates of non-small cell lung cancer: Is interpretation affected by type of fixation? Cancer Cytopathol 2019; 128:100-106. [PMID: 31851430 DOI: 10.1002/cncy.22216] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 10/11/2019] [Accepted: 10/31/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Much of the reluctance about using cytology specimens rather than histology specimens to assess programmed death ligand 1 (PD-L1) expression for guiding the use of immune modulating drugs in the management of non-small cell lung cancer (NSCLC) is based on the belief that the alcohol-based fixatives favored by cytopathologists might reduce the antigenicity of PD-L1 and lead to artifactually low expression levels and false-negative reporting. Therefore, this study was performed to determine whether there is any difference in PD-L1 expression between endobronchial ultrasound (EBUS)-guided aspirates of NSCLC fixed in alcohol-based fixatives and those fixed in neutral buffered formalin (NBF), the standard laboratory fixative for histology specimens. METHODS The expression of PD-L1 was compared in 50 paired EBUS aspirates of NSCLC taken from the same lymph node during the same procedure. One aspirate of each pair was fixed in an alcohol-based fixative, and the other was fixed in NBF. RESULTS In none of the 50 pairs was there any significant difference, qualitative or quantitative, in the strength, pattern, or extent of PD-L1 expression. In the great majority, the expression was identical, regardless of fixation. CONCLUSIONS There is no evidence from this study showing that the use of alcohol-based fixatives has any effect on the expression of PD-L1 or its interpretation. Notwithstanding the general challenges in accurately assessing such expression in cytology specimens, pathologists should feel able to interpret them with confidence, and clinicians should feel able to rely on the results.
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Affiliation(s)
- John R Gosney
- Department of Cellular Pathology, Royal Liverpool University Hospital, Liverpool, United Kingdom
| | - Alexander Haragan
- Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, United Kingdom
| | - Claire Chadwick
- Department of Cellular Pathology, Royal Liverpool University Hospital, Liverpool, United Kingdom
| | - Tom E Giles
- Department of Cellular Pathology, Royal Liverpool University Hospital, Liverpool, United Kingdom
| | - Seamus Grundy
- Department of Respiratory Medicine, Salford Royal National Health Service Foundation Trust, Salford, United Kingdom
| | - Victoria Tippett
- Department of Respiratory Medicine, Aintree University Hospital, Liverpool, United Kingdom
| | - Krishna P Gumparthy
- Department of Histopathology, Wirral University Teaching Hospital, Birkenhead, United Kingdom
- Department of Respiratory Medicine, Wirral University Teaching Hospital, Birkenhead, United Kingdom
| | - Andrew Wight
- Department of Histopathology, Wirral University Teaching Hospital, Birkenhead, United Kingdom
- Department of Respiratory Medicine, Wirral University Teaching Hospital, Birkenhead, United Kingdom
| | - Hock G Tan
- Department of Histopathology, Wirral University Teaching Hospital, Birkenhead, United Kingdom
- Department of Respiratory Medicine, Wirral University Teaching Hospital, Birkenhead, United Kingdom
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Georgiadis A, Durham JN, Keefer LA, Bartlett BR, Zielonka M, Murphy D, White JR, Lu S, Verner EL, Ruan F, Riley D, Anders RA, Gedvilaite E, Angiuoli S, Jones S, Velculescu VE, Le DT, Diaz LA, Sausen M. Noninvasive Detection of Microsatellite Instability and High Tumor Mutation Burden in Cancer Patients Treated with PD-1 Blockade. Clin Cancer Res 2019; 25:7024-7034. [PMID: 31506389 DOI: 10.1158/1078-0432.ccr-19-1372] [Citation(s) in RCA: 95] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 05/17/2019] [Accepted: 08/07/2019] [Indexed: 12/12/2022]
Abstract
PURPOSE Microsatellite instability (MSI) and high tumor mutation burden (TMB-High) are promising pan-tumor biomarkers used to select patients for treatment with immune checkpoint blockade; however, real-time sequencing of unresectable or metastatic solid tumors is often challenging. We report a noninvasive approach for detection of MSI and TMB-High in the circulation of patients. EXPERIMENTAL DESIGN We developed an approach that utilized a hybrid-capture-based 98-kb pan-cancer gene panel, including targeted microsatellite regions. A multifactorial error correction method and a novel peak-finding algorithm were established to identify rare MSI frameshift alleles in cell-free DNA (cfDNA). RESULTS Through analysis of cfDNA derived from a combination of healthy donors and patients with metastatic cancer, the error correction and peak-finding approaches produced a specificity of >99% (n = 163) and sensitivities of 78% (n = 23) and 67% (n = 15), respectively, for MSI and TMB-High. For patients treated with PD-1 blockade, we demonstrated that MSI and TMB-High in pretreatment plasma predicted progression-free survival (hazard ratios: 0.21 and 0.23, P = 0.001 and 0.003, respectively). In addition, we analyzed cfDNA from longitudinally collected plasma samples obtained during therapy to identify patients who achieved durable response to PD-1 blockade. CONCLUSIONS These analyses demonstrate the feasibility of noninvasive pan-cancer screening and monitoring of patients who exhibit MSI or TMB-High and have a high likelihood of responding to immune checkpoint blockade.See related commentary by Wang and Ajani, p. 6887.
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Affiliation(s)
| | - Jennifer N Durham
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | | | - Bjarne R Bartlett
- Ludwig Center and Howard Hughes Medical Institute at Johns Hopkins, Baltimore, Maryland
- Swim Across America Laboratory at Johns Hopkins, Baltimore, Maryland
| | | | - Derek Murphy
- Personal Genome Diagnostics, Baltimore, Maryland
| | | | - Steve Lu
- Ludwig Center and Howard Hughes Medical Institute at Johns Hopkins, Baltimore, Maryland
| | | | - Finey Ruan
- Personal Genome Diagnostics, Baltimore, Maryland
| | - David Riley
- Personal Genome Diagnostics, Baltimore, Maryland
| | - Robert A Anders
- Department of Pathology, Bloomberg-Kimmel Institute for Cancer Immunotherapy at Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Erika Gedvilaite
- Center for Molecular Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Sam Angiuoli
- Personal Genome Diagnostics, Baltimore, Maryland
| | - Siân Jones
- Personal Genome Diagnostics, Baltimore, Maryland
| | - Victor E Velculescu
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Dung T Le
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Luis A Diaz
- Division of Solid Tumor Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York.
| | - Mark Sausen
- Personal Genome Diagnostics, Baltimore, Maryland.
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15
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Zong Y, Li Q, Zhang F, Xian X, Wang S, Xia J, Li J, Tuo Z, Xiao G, Liu L, Li G, Zhang S, Wu G, Liu J. SDH5 Depletion Enhances Radiosensitivity by Regulating p53: A New Method for Noninvasive Prediction of Radiotherapy Response. Am J Cancer Res 2019; 9:6380-6395. [PMID: 31588224 PMCID: PMC6771232 DOI: 10.7150/thno.34443] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 07/23/2019] [Indexed: 01/16/2023] Open
Abstract
Radiotherapy is an effective treatment for lung cancer but lacks a reliable prediction method. Cell-free nucleic acids in plasma have been reported as a novel tumor marker. Here, we evaluate circulating succinate dehydrogenase 5 (SDH5) mRNA in plasma and SDH5 protein in tumors, assess their predictive value in lung cancer patients undergoing radiotherapy, and explore the underlying mechanisms. Methods: SDH5 expression was measured in peripheral blood samples and fresh tumor specimens from 208 non-small cell lung cancer (NSCLC) patients and correlated with clinical outcomes. SDH5 knockout mice and human xenograft mice were used to evaluate radiosensitivity. Cell growth, apoptosis, and the DNA damage response were assessed. Relevant RNA and protein levels were analyzed by qRT-PCR and Western blotting. Immunoprecipitation and GST pulldown assays were performed to detect protein-protein interactions. Polyubiquitination of p53 was examined by an in vitro ubiquitination assay. Results: Plasma and tumor SDH5 mRNA levels were positively correlated (rho=0.894, P<0.001). Patients with relatively low SDH5 levels in plasma (0.47, 0.12-0.89) and tumors (3.85, 0.96-7.23) had a better prognosis after radiotherapy (median PFS: 30.0 versus 15.0 months, hazard ratio: 0.276, 95% CI: 0.201-0.379, P<0.001). In SDH5 knockout mice, the lung epithelial cells exhibited increased DNA damage after radiation. In human lung xenograft mice, SDH5-deficient tumors had a smaller volume after radiotherapy. Furthermore, SDH5 depletion inhibits p53 degradation via the ubiquitin/proteasome pathway, which promotes apoptosis and enhances radiosensitivity in NSCLC. Conclusion: Our findings provide a novel noninvasive method for prediction of response to radiotherapy and may have significant implications for cancer radiotherapy.
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16
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Beck KS, Kim SJ, Kang JH, Han DH, Jung JI, Lee KY. CT-guided transthoracic needle biopsy for evaluation of PD-L1 expression: Comparison of 22C3 and SP263 assays. Thorac Cancer 2019; 10:1612-1618. [PMID: 31237079 PMCID: PMC6611068 DOI: 10.1111/1759-7714.13126] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 06/03/2019] [Accepted: 06/05/2019] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Although there have been several studies on concordance of different assays testing programmed cell death ligand-1 (PD-L1) expression using surgical specimens, studies using real-world biopsy specimens are scarce. However, many of the non-small cell lung cancer (NSCLC) cases requiring immunotherapy and thus PD-L1 testing are unresectable having to rely on small biopsy results. Therefore, we sought to assess the concordance of two diagnostic assays (22C3 and SP263) in evaluating PD-L1 expression using specimens from CT-guided transthoracic needle biopsy (TNB) specimens in a routine clinical setting. METHODS A total of 202 NSCLC cases that underwent CT-guided TNB from April 2017 to February 2018 were retrospectively reviewed. Biopsy specimens tested with both 22C3 and SP263 assays were included. Concordance of PD-L1 expression levels determined by two assays was assessed using intraclass correlation coefficient, and the agreement of dichotomized values at various cutoffs (1%, 25%, and 50%) were assessed using Cohen's κ coefficient of agreement. RESULTS A total of 80 patients (M:F = 47:33, mean age: 68.0 years) were included in the study. Concordance of PD-L1 expression levels was high (intraclass coefficient: 0.892) between 22C3 and SP263 assays. Agreements at cutoff levels of 1%, 25%, and 50% were also good, with κ values of 0.878, 0.698, and 0.790, respectively. Positive percent agreement was 93.2%, 100.0%, and 95.2% for agreements at 1%, 25%, and 50%. CONCLUSION There is a high concordance of PD-L1 expression evaluated with 22C3 and SP263 assays using CT-guided TNB specimens.
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Affiliation(s)
- Kyongmin S Beck
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Seung Joon Kim
- Division of Pulmonology, Department of Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jin Hyoung Kang
- Division of Oncology, Department of Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Dae Hee Han
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jung Im Jung
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Kyo Young Lee
- Department of Hospital Pathology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Pritzker KPH, Nieminen HJ. Needle Biopsy Adequacy in the Era of Precision Medicine and Value-Based Health Care. Arch Pathol Lab Med 2019; 143:1399-1415. [PMID: 31100015 DOI: 10.5858/arpa.2018-0463-ra] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT.— Needle biopsy of diseased tissue is an essential diagnostic tool that is becoming even more important as precision medicine develops. However, the capability of this modality to efficiently provide samples adequate for diagnostic and prognostic analysis remains quite limited relative to current diagnostic needs. For physicians and patients, inadequate biopsy frequently leads to diagnostic delay, procedure duplication, or insufficient information about tumor biology leading to delay in treatment; for health systems, this results in substantial incremental costs and inefficient use of scarce specialized diagnostic resources. OBJECTIVE.— To review current needle biopsy technology, devices, and practice with a perspective to identify current limitations and opportunities for improvement in the context of advancing precision medicine. DATA SOURCES.— PubMed searches of fine-needle aspiration and core needle biopsy devices and similar technologies were made generally, by tissue site, and by adequacy as well as by health economics of these technologies. CONCLUSIONS.— Needle biopsy adequacy can be improved by recognizing the importance of this diagnostic tool by promoting common criteria for needle biopsy adequacy; by optimizing needle biopsy procedural technique, technologies, clinical practice, professional education, and quality assurance; and by bundling biopsy procedure costs with downstream diagnostic modalities to provide better accountability and incentives to improve the diagnostic process.
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Affiliation(s)
- Kenneth P H Pritzker
- From the Departments of Laboratory Medicine and Pathobiology, and Surgery, University of Toronto, Toronto, Ontario, Canada (Dr Pritzker); and the Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland (Dr Nieminen)
| | - Heikki J Nieminen
- From the Departments of Laboratory Medicine and Pathobiology, and Surgery, University of Toronto, Toronto, Ontario, Canada (Dr Pritzker); and the Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland (Dr Nieminen)
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18
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Stella GM, Bortolotto C, Filippi AR. Intrathoracic core needle biopsy and repeat biopsy for PD-L1 evaluation in non-small cell lung cancer. J Thorac Dis 2019; 10:S4031-S4033. [PMID: 30631547 DOI: 10.21037/jtd.2018.09.92] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Giulia Maria Stella
- Department of Medical Sciences and Infectious Diseases, Unit of Respiratory System Diseases, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Chandra Bortolotto
- Department of Intensive Medicine, Unit of Radiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Andrea Riccardo Filippi
- Department of Medical Sciences and Infectious Diseases, Unit of Radiation Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
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19
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Lee KH, Lim KY, Suh YJ, Hur J, Han DH, Kang MJ, Choo JY, Kim C, Kim JI, Yoon SH, Lee W, Park CM. Nondiagnostic Percutaneous Transthoracic Needle Biopsy of Lung Lesions: A Multicenter Study of Malignancy Risk. Radiology 2018; 290:814-823. [PMID: 30561276 DOI: 10.1148/radiol.2018181482] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Purpose To evaluate the malignancy risk of lung lesions that show nondiagnostic results at transthoracic needle biopsy (PTNB) of the lung and to identify any malignancy-associated risk factors in each nondiagnostic category. Materials and Methods In this retrospective study, 9384 initial PTNBs (9239 patients [mean age, 65 years; age range, 20-99 years] consisting of 5729 men [mean age, 66 years; age range, 20-99 years] and 3510 women [mean age, 63 years; age range, 20-94 years]) were performed in eight institutions between January 2010 and December 2014. PTNB results were categorized as diagnostic (malignant or specifically benign) or nondiagnostic (nonspecific benign pathologic findings, atypical cells, or insufficient specimen), and the proportion of final malignant diagnoses per nondiagnostic category was obtained. Malignancy-associated factors were determined by using multivariable analyses. Results Nondiagnostic results were present in 27.6% (2590 of 9384) of PTNBs. Proportions of final malignant diagnoses were 21.3% (339 of 1592) for nonspecific benignities, 90.1% (503 of 558) for atypical cells, and 46.6% (205 of 440) for insufficient specimens. In the nonspecific benign category, granulomatous inflammation (odds ratio [OR], 0.04; 95% confidence interval [CI]: 0.02, 0.12; P < .001), abscess (OR, 0.04; 95% CI: 0.01, 0.28; P = .001), and organizing pneumonia (OR, 0.05; 95% CI: 0.01, 0.23; P < .001) were demonstrated to be important factors negating malignancy. Atypical cells suspicious for malignancy were more associated with malignancy (OR, 6.3; 95% CI: 1.9, 21.0; P = .003) than were atypical cells of indeterminate malignancy. All 130 lesions with atypical cells suggestive of malignancy were finally malignant. Conclusion After nondiagnostic lung biopsies, lesions categorized as atypical cell lesions have a high likelihood of malignancy, with somewhat lower likelihood for lesions with insufficient specimens and nonspecific benign categories. © RSNA, 2018 Online supplemental material is available for this article. See also the editorial by Elicker in this issue.
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Affiliation(s)
- Kyung Hee Lee
- From the Department of Radiology, Seoul National University Bundang Hospital, Gyeonggi-do, South Korea (K.H.L.); Department of Radiology, National Cancer Center, Gyeonggi-do, South Korea (K.Y.L.); Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea (Y.J.S., J.H.); Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea (J.H.); Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea (D.H.H.); Department of Radiology, Inje University Sanggyepaik Hospital, Seoul, South Korea (M.J.K.); Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Gyeonggi-do, South Korea (J.Y.C., C.K.); Department of Radiology, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, South Korea (J.I.K.); Department of Radiology, Seoul National University College of Medicine, Seoul, South Korea (S.H.Y., C.M.P.); Department of Statistics, Inha University, Incheon, South Korea (W.L.); and Institute of Radiation Medicine, Seoul National University Medical Research Center, 101 Daehak-ro, Jongno-gu, Seoul 03080, South Korea (C.M.P.)
| | - Kun Young Lim
- From the Department of Radiology, Seoul National University Bundang Hospital, Gyeonggi-do, South Korea (K.H.L.); Department of Radiology, National Cancer Center, Gyeonggi-do, South Korea (K.Y.L.); Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea (Y.J.S., J.H.); Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea (J.H.); Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea (D.H.H.); Department of Radiology, Inje University Sanggyepaik Hospital, Seoul, South Korea (M.J.K.); Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Gyeonggi-do, South Korea (J.Y.C., C.K.); Department of Radiology, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, South Korea (J.I.K.); Department of Radiology, Seoul National University College of Medicine, Seoul, South Korea (S.H.Y., C.M.P.); Department of Statistics, Inha University, Incheon, South Korea (W.L.); and Institute of Radiation Medicine, Seoul National University Medical Research Center, 101 Daehak-ro, Jongno-gu, Seoul 03080, South Korea (C.M.P.)
| | - Young Joo Suh
- From the Department of Radiology, Seoul National University Bundang Hospital, Gyeonggi-do, South Korea (K.H.L.); Department of Radiology, National Cancer Center, Gyeonggi-do, South Korea (K.Y.L.); Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea (Y.J.S., J.H.); Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea (J.H.); Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea (D.H.H.); Department of Radiology, Inje University Sanggyepaik Hospital, Seoul, South Korea (M.J.K.); Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Gyeonggi-do, South Korea (J.Y.C., C.K.); Department of Radiology, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, South Korea (J.I.K.); Department of Radiology, Seoul National University College of Medicine, Seoul, South Korea (S.H.Y., C.M.P.); Department of Statistics, Inha University, Incheon, South Korea (W.L.); and Institute of Radiation Medicine, Seoul National University Medical Research Center, 101 Daehak-ro, Jongno-gu, Seoul 03080, South Korea (C.M.P.)
| | - Jin Hur
- From the Department of Radiology, Seoul National University Bundang Hospital, Gyeonggi-do, South Korea (K.H.L.); Department of Radiology, National Cancer Center, Gyeonggi-do, South Korea (K.Y.L.); Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea (Y.J.S., J.H.); Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea (J.H.); Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea (D.H.H.); Department of Radiology, Inje University Sanggyepaik Hospital, Seoul, South Korea (M.J.K.); Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Gyeonggi-do, South Korea (J.Y.C., C.K.); Department of Radiology, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, South Korea (J.I.K.); Department of Radiology, Seoul National University College of Medicine, Seoul, South Korea (S.H.Y., C.M.P.); Department of Statistics, Inha University, Incheon, South Korea (W.L.); and Institute of Radiation Medicine, Seoul National University Medical Research Center, 101 Daehak-ro, Jongno-gu, Seoul 03080, South Korea (C.M.P.)
| | - Dae Hee Han
- From the Department of Radiology, Seoul National University Bundang Hospital, Gyeonggi-do, South Korea (K.H.L.); Department of Radiology, National Cancer Center, Gyeonggi-do, South Korea (K.Y.L.); Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea (Y.J.S., J.H.); Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea (J.H.); Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea (D.H.H.); Department of Radiology, Inje University Sanggyepaik Hospital, Seoul, South Korea (M.J.K.); Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Gyeonggi-do, South Korea (J.Y.C., C.K.); Department of Radiology, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, South Korea (J.I.K.); Department of Radiology, Seoul National University College of Medicine, Seoul, South Korea (S.H.Y., C.M.P.); Department of Statistics, Inha University, Incheon, South Korea (W.L.); and Institute of Radiation Medicine, Seoul National University Medical Research Center, 101 Daehak-ro, Jongno-gu, Seoul 03080, South Korea (C.M.P.)
| | - Mi-Jin Kang
- From the Department of Radiology, Seoul National University Bundang Hospital, Gyeonggi-do, South Korea (K.H.L.); Department of Radiology, National Cancer Center, Gyeonggi-do, South Korea (K.Y.L.); Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea (Y.J.S., J.H.); Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea (J.H.); Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea (D.H.H.); Department of Radiology, Inje University Sanggyepaik Hospital, Seoul, South Korea (M.J.K.); Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Gyeonggi-do, South Korea (J.Y.C., C.K.); Department of Radiology, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, South Korea (J.I.K.); Department of Radiology, Seoul National University College of Medicine, Seoul, South Korea (S.H.Y., C.M.P.); Department of Statistics, Inha University, Incheon, South Korea (W.L.); and Institute of Radiation Medicine, Seoul National University Medical Research Center, 101 Daehak-ro, Jongno-gu, Seoul 03080, South Korea (C.M.P.)
| | - Ji Yung Choo
- From the Department of Radiology, Seoul National University Bundang Hospital, Gyeonggi-do, South Korea (K.H.L.); Department of Radiology, National Cancer Center, Gyeonggi-do, South Korea (K.Y.L.); Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea (Y.J.S., J.H.); Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea (J.H.); Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea (D.H.H.); Department of Radiology, Inje University Sanggyepaik Hospital, Seoul, South Korea (M.J.K.); Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Gyeonggi-do, South Korea (J.Y.C., C.K.); Department of Radiology, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, South Korea (J.I.K.); Department of Radiology, Seoul National University College of Medicine, Seoul, South Korea (S.H.Y., C.M.P.); Department of Statistics, Inha University, Incheon, South Korea (W.L.); and Institute of Radiation Medicine, Seoul National University Medical Research Center, 101 Daehak-ro, Jongno-gu, Seoul 03080, South Korea (C.M.P.)
| | - Cherry Kim
- From the Department of Radiology, Seoul National University Bundang Hospital, Gyeonggi-do, South Korea (K.H.L.); Department of Radiology, National Cancer Center, Gyeonggi-do, South Korea (K.Y.L.); Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea (Y.J.S., J.H.); Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea (J.H.); Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea (D.H.H.); Department of Radiology, Inje University Sanggyepaik Hospital, Seoul, South Korea (M.J.K.); Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Gyeonggi-do, South Korea (J.Y.C., C.K.); Department of Radiology, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, South Korea (J.I.K.); Department of Radiology, Seoul National University College of Medicine, Seoul, South Korea (S.H.Y., C.M.P.); Department of Statistics, Inha University, Incheon, South Korea (W.L.); and Institute of Radiation Medicine, Seoul National University Medical Research Center, 101 Daehak-ro, Jongno-gu, Seoul 03080, South Korea (C.M.P.)
| | - Jung Im Kim
- From the Department of Radiology, Seoul National University Bundang Hospital, Gyeonggi-do, South Korea (K.H.L.); Department of Radiology, National Cancer Center, Gyeonggi-do, South Korea (K.Y.L.); Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea (Y.J.S., J.H.); Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea (J.H.); Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea (D.H.H.); Department of Radiology, Inje University Sanggyepaik Hospital, Seoul, South Korea (M.J.K.); Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Gyeonggi-do, South Korea (J.Y.C., C.K.); Department of Radiology, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, South Korea (J.I.K.); Department of Radiology, Seoul National University College of Medicine, Seoul, South Korea (S.H.Y., C.M.P.); Department of Statistics, Inha University, Incheon, South Korea (W.L.); and Institute of Radiation Medicine, Seoul National University Medical Research Center, 101 Daehak-ro, Jongno-gu, Seoul 03080, South Korea (C.M.P.)
| | - Soon Ho Yoon
- From the Department of Radiology, Seoul National University Bundang Hospital, Gyeonggi-do, South Korea (K.H.L.); Department of Radiology, National Cancer Center, Gyeonggi-do, South Korea (K.Y.L.); Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea (Y.J.S., J.H.); Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea (J.H.); Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea (D.H.H.); Department of Radiology, Inje University Sanggyepaik Hospital, Seoul, South Korea (M.J.K.); Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Gyeonggi-do, South Korea (J.Y.C., C.K.); Department of Radiology, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, South Korea (J.I.K.); Department of Radiology, Seoul National University College of Medicine, Seoul, South Korea (S.H.Y., C.M.P.); Department of Statistics, Inha University, Incheon, South Korea (W.L.); and Institute of Radiation Medicine, Seoul National University Medical Research Center, 101 Daehak-ro, Jongno-gu, Seoul 03080, South Korea (C.M.P.)
| | - Woojoo Lee
- From the Department of Radiology, Seoul National University Bundang Hospital, Gyeonggi-do, South Korea (K.H.L.); Department of Radiology, National Cancer Center, Gyeonggi-do, South Korea (K.Y.L.); Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea (Y.J.S., J.H.); Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea (J.H.); Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea (D.H.H.); Department of Radiology, Inje University Sanggyepaik Hospital, Seoul, South Korea (M.J.K.); Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Gyeonggi-do, South Korea (J.Y.C., C.K.); Department of Radiology, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, South Korea (J.I.K.); Department of Radiology, Seoul National University College of Medicine, Seoul, South Korea (S.H.Y., C.M.P.); Department of Statistics, Inha University, Incheon, South Korea (W.L.); and Institute of Radiation Medicine, Seoul National University Medical Research Center, 101 Daehak-ro, Jongno-gu, Seoul 03080, South Korea (C.M.P.)
| | - Chang Min Park
- From the Department of Radiology, Seoul National University Bundang Hospital, Gyeonggi-do, South Korea (K.H.L.); Department of Radiology, National Cancer Center, Gyeonggi-do, South Korea (K.Y.L.); Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea (Y.J.S., J.H.); Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea (J.H.); Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea (D.H.H.); Department of Radiology, Inje University Sanggyepaik Hospital, Seoul, South Korea (M.J.K.); Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Gyeonggi-do, South Korea (J.Y.C., C.K.); Department of Radiology, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, South Korea (J.I.K.); Department of Radiology, Seoul National University College of Medicine, Seoul, South Korea (S.H.Y., C.M.P.); Department of Statistics, Inha University, Incheon, South Korea (W.L.); and Institute of Radiation Medicine, Seoul National University Medical Research Center, 101 Daehak-ro, Jongno-gu, Seoul 03080, South Korea (C.M.P.)
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Pfeil A, Cazzato RL, Barbé L, De Marini P, Chiang JB, Garnon J, Renaud P, Gangi A. Robotically Assisted CBCT-Guided Needle Insertions: Preliminary Results in a Phantom Model. Cardiovasc Intervent Radiol 2018; 42:283-288. [DOI: 10.1007/s00270-018-2088-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2018] [Accepted: 10/01/2018] [Indexed: 12/18/2022]
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21
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Naidich DP. Low Dose Lung CT Screening in an Asian Population. Acad Radiol 2018; 25:1237-1239. [PMID: 30017500 DOI: 10.1016/j.acra.2018.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 06/06/2018] [Indexed: 02/06/2023]
Affiliation(s)
- David P Naidich
- Department of Radiology, New York University-Langone Medical Center, Center for Biological Imaging, 660 1st Ave, New York, NY 10016.
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22
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Zarogoulidis P, Papadopoulos V, Maragouli E, Papatsibas G, Karapantzos I, Bai C, Huang H. Tumor heterogenicity: multiple needle biopsies from different lesion sites-key to successful targeted therapy and immunotherapy. Transl Lung Cancer Res 2018. [PMID: 29531904 DOI: 10.21037/tlcr.2018.01.07] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- Paul Zarogoulidis
- Pulmonary Department-Oncology Unit, "Theageneio" Cancer Hospital, Thessaloniki, Greece
| | | | - Elena Maragouli
- Oncology Department, University of Thessaly, Larissa, Greece
| | | | - Ilias Karapantzos
- Ear, Nose and Throat Department, "Saint Luke" Private Hospital, Panorama, Thessaloniki, Greece
| | - Chong Bai
- Department of Respiratory and Critical Care Medicine, Changhai Hospital, Second Military Medical University, Shanghai 200000, China
| | - Haidong Huang
- Department of Respiratory and Critical Care Medicine, Changhai Hospital, Second Military Medical University, Shanghai 200000, China
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