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Malapelle U, Leighl N, Addeo A, Hershkovitz D, Hochmair MJ, Khorshid O, Länger F, de Marinis F, Peled N, Sheffield BS, Smit EF, Viteri S, Wolf J, Venturini F, O'Hara RM, Rolfo C. Recommendations for reporting tissue and circulating tumour (ct)DNA next-generation sequencing results in non-small cell lung cancer. Br J Cancer 2024; 131:212-219. [PMID: 38750115 PMCID: PMC11263606 DOI: 10.1038/s41416-024-02709-4] [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: 01/04/2024] [Revised: 04/25/2024] [Accepted: 04/30/2024] [Indexed: 07/24/2024] Open
Abstract
Non-small cell lung cancer is a heterogeneous disease and molecular characterisation plays an important role in its clinical management. Next-generation sequencing-based panel testing enables many molecular alterations to be interrogated simultaneously, allowing for comprehensive identification of actionable oncogenic drivers (and co-mutations) and appropriate matching of patients with targeted therapies. Despite consensus in international guidelines on the importance of broad molecular profiling, adoption of next-generation sequencing varies globally. One of the barriers to its successful implementation is a lack of accepted standards and guidelines specifically for the reporting and clinical annotation of next-generation sequencing results. Based on roundtable discussions between pathologists and oncologists, we provide best practice recommendations for the reporting of next-generation sequencing results in non-small cell lung cancer to facilitate its use and enable easy interpretation for physicians. These are intended to complement existing guidelines related to the use of next-generation sequencing (solid and liquid). Here, we discuss next-generation sequencing workflows, the structure of next-generation sequencing reports, and our recommendations for best practice thereof. The aim of these recommendations and considerations is ultimately to ensure that reports are fully interpretable, and that the most appropriate treatment options are selected based on robust molecular profiles in well-defined reports.
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Affiliation(s)
- Umberto Malapelle
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Natasha Leighl
- Department of Medical Oncology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Alfredo Addeo
- Oncology Unit, Geneva University Hospital, Geneva, Switzerland
| | | | - Maximilian J Hochmair
- Department of Respiratory & Critical Care Medicine, Karl Landsteiner Institute of Lung Research & Pulmonary Oncology, Klinik Floridsdorf, Vienna, Austria
| | - Ola Khorshid
- National Cancer Institute, Cairo University, Cairo, Egypt
| | - Florian Länger
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Filippo de Marinis
- Division of Thoracic Oncology, European Institute of Oncology, IRCCS, Milan, Italy
| | - Nir Peled
- Helmesely Cancer Center, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Brandon S Sheffield
- Division of Advanced Diagnostics, William Osler Health System, Brampton, ON, Canada
| | - Egbert F Smit
- Department of Pulmonary Diseases, Leiden University Medical Centre, Leiden, The Netherlands
| | - Santiago Viteri
- UOMI Cancer Center, Clínica Mi Tres Torres, Barcelona, Spain
| | - Jürgen Wolf
- Lung Cancer Group Cologne, Center for Integrated Oncology, University Hospital of Cologne, Cologne, Germany
| | | | | | - Christian Rolfo
- Center for Thoracic Oncology, Tisch Cancer Institute, Mount Sinai Medical System & Icahn School of Medicine, New York, NY, USA.
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2
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Ilié M, Goffinet S, Rignol G, Lespinet-Fabre V, Lalvée S, Bordone O, Zahaf K, Bonnetaud C, Washetine K, Lassalle S, Long-Mira E, Heeke S, Hofman V, Hofman P. Shifting from Immunohistochemistry to Screen for ALK Rearrangements: Real-World Experience in a Large Single-Center Cohort of Patients with Non-Small-Cell Lung Cancer. Cancers (Basel) 2024; 16:2219. [PMID: 38927925 PMCID: PMC11201761 DOI: 10.3390/cancers16122219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Revised: 06/10/2024] [Accepted: 06/11/2024] [Indexed: 06/28/2024] Open
Abstract
The identification of ALK fusions in advanced non-small-cell lung carcinoma (aNSCLC) is mandatory for targeted therapy. The current diagnostic approach employs an algorithm using ALK immunohistochemistry (IHC) screening, followed by confirmation through ALK FISH and/or next-generation sequencing (NGS). Challenges arise due to the infrequency of ALK fusions (3-7% of aNSCLC), the suboptimal specificity of ALK IHC and ALK FISH, and the growing molecular demands placed on small tissue samples, leading to interpretative, tissue availability, and time-related issues. This study investigates the effectiveness of RNA NGS as a reflex test for identifying ALK fusions in NSCLC, with the goal of replacing ALK IHC in the systematic screening process. The evaluation included 1246 NSCLC cases using paired techniques: ALK IHC, ALK FISH, and ALK NGS. ALK IHC identified 51 positive cases (4%), while RNA NGS detected ALK alterations in 59 cases (4.8%). Of the 59 ALK-positive cases identified via NGS, 53 (89.8%) were confirmed to be positive. This included 51 cases detected via both FISH and IHC, and 2 cases detected only via FISH, as they were completely negative according to IHC. The combined reporting time for ALK IHC and ALK FISH averaged 13 days, whereas ALK IHC and RNA NGS reports were obtained in an average of 4 days. These results emphasize the advantage of replacing systematic ALK IHC screening with RNA NGS reflex testing for a more comprehensive and accurate assessment of ALK status.
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Affiliation(s)
- Marius Ilié
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, Nice University Hospital, FHU OncoAge, IHU RespirERA, 06000 Nice, France; (M.I.); (S.G.); (G.R.); (V.L.-F.); (S.L.); (K.Z.); (C.B.); (K.W.); (S.L.); (E.L.-M.); (V.H.)
- Hospital-Integrated Biobank (BB-0033-00025), Pasteur Hospital, Nice University Hospital, FHU OncoAge, IHU RespirERA, 06000 Nice, France;
| | - Samantha Goffinet
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, Nice University Hospital, FHU OncoAge, IHU RespirERA, 06000 Nice, France; (M.I.); (S.G.); (G.R.); (V.L.-F.); (S.L.); (K.Z.); (C.B.); (K.W.); (S.L.); (E.L.-M.); (V.H.)
- Hospital-Integrated Biobank (BB-0033-00025), Pasteur Hospital, Nice University Hospital, FHU OncoAge, IHU RespirERA, 06000 Nice, France;
| | - Guylène Rignol
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, Nice University Hospital, FHU OncoAge, IHU RespirERA, 06000 Nice, France; (M.I.); (S.G.); (G.R.); (V.L.-F.); (S.L.); (K.Z.); (C.B.); (K.W.); (S.L.); (E.L.-M.); (V.H.)
- Hospital-Integrated Biobank (BB-0033-00025), Pasteur Hospital, Nice University Hospital, FHU OncoAge, IHU RespirERA, 06000 Nice, France;
| | - Virginie Lespinet-Fabre
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, Nice University Hospital, FHU OncoAge, IHU RespirERA, 06000 Nice, France; (M.I.); (S.G.); (G.R.); (V.L.-F.); (S.L.); (K.Z.); (C.B.); (K.W.); (S.L.); (E.L.-M.); (V.H.)
| | - Salomé Lalvée
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, Nice University Hospital, FHU OncoAge, IHU RespirERA, 06000 Nice, France; (M.I.); (S.G.); (G.R.); (V.L.-F.); (S.L.); (K.Z.); (C.B.); (K.W.); (S.L.); (E.L.-M.); (V.H.)
| | - Olivier Bordone
- Hospital-Integrated Biobank (BB-0033-00025), Pasteur Hospital, Nice University Hospital, FHU OncoAge, IHU RespirERA, 06000 Nice, France;
| | - Katia Zahaf
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, Nice University Hospital, FHU OncoAge, IHU RespirERA, 06000 Nice, France; (M.I.); (S.G.); (G.R.); (V.L.-F.); (S.L.); (K.Z.); (C.B.); (K.W.); (S.L.); (E.L.-M.); (V.H.)
| | - Christelle Bonnetaud
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, Nice University Hospital, FHU OncoAge, IHU RespirERA, 06000 Nice, France; (M.I.); (S.G.); (G.R.); (V.L.-F.); (S.L.); (K.Z.); (C.B.); (K.W.); (S.L.); (E.L.-M.); (V.H.)
- Hospital-Integrated Biobank (BB-0033-00025), Pasteur Hospital, Nice University Hospital, FHU OncoAge, IHU RespirERA, 06000 Nice, France;
| | - Kevin Washetine
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, Nice University Hospital, FHU OncoAge, IHU RespirERA, 06000 Nice, France; (M.I.); (S.G.); (G.R.); (V.L.-F.); (S.L.); (K.Z.); (C.B.); (K.W.); (S.L.); (E.L.-M.); (V.H.)
- Hospital-Integrated Biobank (BB-0033-00025), Pasteur Hospital, Nice University Hospital, FHU OncoAge, IHU RespirERA, 06000 Nice, France;
| | - Sandra Lassalle
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, Nice University Hospital, FHU OncoAge, IHU RespirERA, 06000 Nice, France; (M.I.); (S.G.); (G.R.); (V.L.-F.); (S.L.); (K.Z.); (C.B.); (K.W.); (S.L.); (E.L.-M.); (V.H.)
- Hospital-Integrated Biobank (BB-0033-00025), Pasteur Hospital, Nice University Hospital, FHU OncoAge, IHU RespirERA, 06000 Nice, France;
| | - Elodie Long-Mira
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, Nice University Hospital, FHU OncoAge, IHU RespirERA, 06000 Nice, France; (M.I.); (S.G.); (G.R.); (V.L.-F.); (S.L.); (K.Z.); (C.B.); (K.W.); (S.L.); (E.L.-M.); (V.H.)
- Hospital-Integrated Biobank (BB-0033-00025), Pasteur Hospital, Nice University Hospital, FHU OncoAge, IHU RespirERA, 06000 Nice, France;
| | - Simon Heeke
- Department of Thoracic/Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA;
| | - Véronique Hofman
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, Nice University Hospital, FHU OncoAge, IHU RespirERA, 06000 Nice, France; (M.I.); (S.G.); (G.R.); (V.L.-F.); (S.L.); (K.Z.); (C.B.); (K.W.); (S.L.); (E.L.-M.); (V.H.)
- Hospital-Integrated Biobank (BB-0033-00025), Pasteur Hospital, Nice University Hospital, FHU OncoAge, IHU RespirERA, 06000 Nice, France;
| | - Paul Hofman
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, Nice University Hospital, FHU OncoAge, IHU RespirERA, 06000 Nice, France; (M.I.); (S.G.); (G.R.); (V.L.-F.); (S.L.); (K.Z.); (C.B.); (K.W.); (S.L.); (E.L.-M.); (V.H.)
- Hospital-Integrated Biobank (BB-0033-00025), Pasteur Hospital, Nice University Hospital, FHU OncoAge, IHU RespirERA, 06000 Nice, France;
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Hofman P, Berezowska S, Kazdal D, Mograbi B, Ilié M, Stenzinger A, Hofman V. Current challenges and practical aspects of molecular pathology for non-small cell lung cancers. Virchows Arch 2024; 484:233-246. [PMID: 37801103 PMCID: PMC10948551 DOI: 10.1007/s00428-023-03651-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 09/05/2023] [Accepted: 09/12/2023] [Indexed: 10/07/2023]
Abstract
The continuing evolution of treatment options in thoracic oncology requires the pathologist to regularly update diagnostic algorithms for management of tumor samples. It is essential to decide on the best way to use tissue biopsies, cytological samples, as well as liquid biopsies to identify the different mandatory predictive biomarkers of lung cancers in a short turnaround time. However, biological resources and laboratory member workforce are limited and may be not sufficient for the increased complexity of molecular pathological analyses and for complementary translational research development. In this context, the surgical pathologist is the only one who makes the decisions whether or not to send specimens to immunohistochemical and molecular pathology platforms. Moreover, the pathologist can rapidly contact the oncologist to obtain a new tissue biopsy and/or a liquid biopsy if he/she considers that the biological material is not sufficient in quantity or quality for assessment of predictive biomarkers. Inadequate control of algorithms and sampling workflow may lead to false negative, inconclusive, and incomplete findings, resulting in inappropriate choice of therapeutic strategy and potentially poor outcome for patients. International guidelines for lung cancer treatment are based on the results of the expression of different proteins and on genomic alterations. These guidelines have been established taking into consideration the best practices to be set up in clinical and molecular pathology laboratories. This review addresses the current predictive biomarkers and algorithms for use in thoracic oncology molecular pathology as well as the central role of the pathologist, notably in the molecular tumor board and her/his participation in the treatment decision-making. The perspectives in this setting will be discussed.
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Affiliation(s)
- Paul Hofman
- Côte d'Azur University, FHU OncoAge, IHU RespirERA, Laboratory of Clinical and Experimental Pathology, BB-0033-00025, Louis Pasteur Hospital, 30 avenue de la voie romaine, BP69, 06001, Nice cedex 01, France.
- Côte d'Azur University, IRCAN, Inserm, CNRS 7284, U1081, Nice, France.
| | - Sabina Berezowska
- Department of Laboratory Medicine and Pathology, Institute of Pathology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Daniel Kazdal
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany
- Centers for Personalized Medicine (ZPM), Heidelberg, Germany
- Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany
| | - Baharia Mograbi
- Côte d'Azur University, FHU OncoAge, IHU RespirERA, Laboratory of Clinical and Experimental Pathology, BB-0033-00025, Louis Pasteur Hospital, 30 avenue de la voie romaine, BP69, 06001, Nice cedex 01, France
- Côte d'Azur University, IRCAN, Inserm, CNRS 7284, U1081, Nice, France
| | - Marius Ilié
- Côte d'Azur University, FHU OncoAge, IHU RespirERA, Laboratory of Clinical and Experimental Pathology, BB-0033-00025, Louis Pasteur Hospital, 30 avenue de la voie romaine, BP69, 06001, Nice cedex 01, France
- Côte d'Azur University, IRCAN, Inserm, CNRS 7284, U1081, Nice, France
| | - Albrecht Stenzinger
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany
- Centers for Personalized Medicine (ZPM), Heidelberg, Germany
- Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany
| | - Véronique Hofman
- Côte d'Azur University, FHU OncoAge, IHU RespirERA, Laboratory of Clinical and Experimental Pathology, BB-0033-00025, Louis Pasteur Hospital, 30 avenue de la voie romaine, BP69, 06001, Nice cedex 01, France
- Côte d'Azur University, IRCAN, Inserm, CNRS 7284, U1081, Nice, France
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Grafham GK, Craddock KJ, Huang W, Louie AV, Zhang L, Hwang DM, Parmar A. Referred molecular testing as a barrier to optimal treatment decision making in metastatic non-small cell lung cancer: Experience at a tertiary academic institution in Canada. Cancer Med 2024; 13:e6886. [PMID: 38317584 PMCID: PMC10905241 DOI: 10.1002/cam4.6886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 11/08/2023] [Accepted: 12/16/2023] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND Molecular testing is critical to guiding treatment approaches in patients with metastatic non-small cell lung cancer (mNSCLC), with testing delays adversely impacting the timeliness of treatment decisions. Here, we aimed to evaluate the time from initial mNSCLC diagnosis to treatment decision (TTD) following implementation of in-house EGFR, ALK, and PD-L1 testing at our institution. METHODS We conducted a retrospective chart review of 165 patients (send-out testing, n = 92; in-house testing, n = 73) with newly diagnosed mNSCLC treated at our institution. Data were compared during the send-out (March 2017-May 2019) and in-house (July 2019-March 2021) testing periods. We performed a detailed workflow analysis to provide insight on the pre-analytic, analytic, and post-analytic intervals that constituted the total TTD. RESULTS TTD was significantly shorter with in-house testing (10 days vs. 18 days, p < 0.0001), driven largely by decreased internal handling and specimen transit times (2 days vs. 3 days, p < 0.0001) and laboratory turnaround times (TAT, 3 days vs. 8 days, p < 0.0001), with 96% of in-house cases meeting the international guideline of a ≤ 10-day intra-laboratory TAT (vs. 74% send-out, p < 0.001). Eighty-eight percent of patients with in-house testing had results available at their first oncology consultation (vs. 52% send-out, p < 0.0001), and all patients with in-house testing had results available at the time of treatment decision (vs. 86% send-out, p = 0.57). CONCLUSION Our results demonstrate the advantages of in-house biomarker testing for mNSCLC at a tertiary oncology center. Incorporation of in-house testing may reduce barriers to offering personalized medicine by improving the time to optimal systemic therapy decision.
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Affiliation(s)
- Grace K. Grafham
- Temerty Faculty of MedicineUniversity of TorontoTorontoOntarioCanada
| | - Kenneth J. Craddock
- Department of Laboratory Medicine and Molecular DiagnosticsSunnybrook Health Sciences CentreTorontoOntarioCanada
- Department of Laboratory Medicine and PathobiologyUniversity of TorontoTorontoOntarioCanada
| | - Weei‐Yuarn Huang
- Department of Laboratory Medicine and Molecular DiagnosticsSunnybrook Health Sciences CentreTorontoOntarioCanada
- Department of Laboratory Medicine and PathobiologyUniversity of TorontoTorontoOntarioCanada
| | - Alexander V. Louie
- Temerty Faculty of MedicineUniversity of TorontoTorontoOntarioCanada
- Department of Radiation OncologySunnybrook Health Sciences CentreTorontoOntarioCanada
| | | | - David M. Hwang
- Department of Laboratory Medicine and Molecular DiagnosticsSunnybrook Health Sciences CentreTorontoOntarioCanada
- Department of Laboratory Medicine and PathobiologyUniversity of TorontoTorontoOntarioCanada
| | - Ambica Parmar
- Temerty Faculty of MedicineUniversity of TorontoTorontoOntarioCanada
- Division of Hematology and Medical Oncology, Department of MedicineSunnybrook Health Sciences CentreTorontoOntarioCanada
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Ferrara M, Pecorino B, D’Agate MG, Angelico G, Capoluongo ED, Malapelle U, Pepe F, Scollo P, Mereu L. Uterine Tumours Resembling Ovarian Sex-Cord Tumors: A Case Report and Review of the Literature. J Clin Med 2023; 12:7131. [PMID: 38002745 PMCID: PMC10671931 DOI: 10.3390/jcm12227131] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 10/18/2023] [Accepted: 11/14/2023] [Indexed: 11/26/2023] Open
Abstract
Uterine tumors resembling ovarian sex-cord tumors (UTROSCT) are thought to develop from pluripotent uterine mesenchymal cells or endometrial stromal cells with secondary sex-cord differentiation. The patient was a 73-year-old postmenopausal woman who had abnormal vaginal bleeding, and she underwent a laparoscopic hysterectomy with bilateral salpingo-oophorectomy. The diagnosis was a case of UTROSCT. A scoping review of the UTROSCT case report present in the literature has been conducted, and 63 articles were found, of which 45 were considered for the 66 clinical cases examined. At the time of diagnosis, six metastatic localizations were found in 59 patients undergoing demolitive surgery (10.2%). Recurrences were diagnosed in 13/59 (22%) patients with multiple locations. A molecular study was performed in 18/66 cases (27.3%) and genetic alterations were found in 10/18 (55.6%) patients. UTROSCTs are considered rare uterine tumors, typically with a favorable prognosis, and are generally considered to have a good prognosis. But, from the review done, they may already manifest themselves at advanced stages, with the possibility of recurrences even at a distance. It would, therefore, be important to be able to define the most aggressive forms and, perhaps, molecular investigation with sequencing could help identify patients most at risk.
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Affiliation(s)
- Martina Ferrara
- Department of Obstetrics and Gynecology, Cannizzaro Hospital, University of Enna “Kore”, 94100 Enna, Italy; (B.P.); (M.G.D.); (P.S.)
| | - Basilio Pecorino
- Department of Obstetrics and Gynecology, Cannizzaro Hospital, University of Enna “Kore”, 94100 Enna, Italy; (B.P.); (M.G.D.); (P.S.)
| | - Maria Gabriella D’Agate
- Department of Obstetrics and Gynecology, Cannizzaro Hospital, University of Enna “Kore”, 94100 Enna, Italy; (B.P.); (M.G.D.); (P.S.)
| | - Giuseppe Angelico
- Department of Anatomic Pathology and Histology, Cannizzaro Hospital, 95100 Catania, Italy;
| | | | - Umberto Malapelle
- Department of Public Health, University of Naples Federico II, 80126 Naples, Italy; (U.M.); (F.P.)
| | - Francesco Pepe
- Department of Public Health, University of Naples Federico II, 80126 Naples, Italy; (U.M.); (F.P.)
| | - Paolo Scollo
- Department of Obstetrics and Gynecology, Cannizzaro Hospital, University of Enna “Kore”, 94100 Enna, Italy; (B.P.); (M.G.D.); (P.S.)
| | - Liliana Mereu
- Department of Obstetrics and Gynecology, Policlinico G Rodolico, CHIRMED, University of Catania, 95124 Catania, Italy
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Bontoux C, Hofman V, Abboute M, Lespinet-Fabre V, Lalvée S, Goffinet S, Bordone O, Long-Mira E, Lassalle S, Murcy F, Rignol G, Heeke S, Ilie M, Hofman P. c-Met immunohistochemistry as reflex test at diagnosis for non-small cell lung cancer: a real-world experience from a monocentric case series. J Clin Pathol 2023:jcp-2023-209202. [PMID: 37940375 DOI: 10.1136/jcp-2023-209202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 10/18/2023] [Indexed: 11/10/2023]
Abstract
AIMS Recent clinical trials have shown promising results with drugs targeting the hepatocyte growth factor receptor (c-Met) for advanced non-small cell lung cancers overexpressing c-Met. We assessed reflex testing of c-Met immunohistochemistry (IHC) at diagnosis for NSCLC in the real-world. METHODS We retrospectively collected clinical, pathological and molecular data of cases diagnosed with NSCLC in our institution from January 2021 to June 2023. We performed c-Met IHC (SP44 clone) and scored the expression using a H-score and a three-tier classification. RESULTS 391 cases with interpretable c-Met IHC staining were included. The median age at diagnosis was 70 years (range 25-89 years) including 234 males (male/female ratio 1:5). 58% of the samples came from surgical resections, 35% from biopsies and 8% from cytological procedures. 52% of cases were classified as c-Met-positive (H-score≥150) and 19% were classified as c-Methigh (≥50%, 3+). 43% of the c-Metneg presented with lymph node and/or visceral metastases at diagnosis vs 55% for c-Methigh (p=0.042). 23% of the adenocarcinomas showed c-Methigh expression vs 3% for squamous cell carcinomas (p=0.004). 27% of the c-Metneg cases had a high PD-L1 expression vs 58% of c-Methigh cases (p<0.001). MET ex14 skipping was present in 8% of the c-Methigh cases. CONCLUSIONS Systematic c-Met testing in daily routine for NSCLC patients is feasible, highlighting a potential correlation with clinicopathological and molecular features.
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Affiliation(s)
- Christophe Bontoux
- IHU RespirERA, FHU OncoAge, Hospital-Integrated Biobank (BB-0033-00025), University Hospital Centre Nice Laboratory of Clinical and Experimental Pathology, Nice, France
- Team 4, Inserm U1081, CNRS 7284, Université Côte d'Azur, Antoine Lacassagne Cancer Center, IRCAN, Nice, France
| | - Veronique Hofman
- Team 4, Inserm U1081, CNRS 7284, Université Côte d'Azur, Antoine Lacassagne Cancer Center, IRCAN, Nice, France
- IHU RespirERA, FHU OncoAge, Hospital-Integrated Biobank (BB-0033-00025), Pasteur Hospital, University Hospital Centre Nice Laboratory of Clinical and Experimental Pathology, Nice, France
| | - Milissa Abboute
- IHU RespirERA, FHU OncoAge, Hospital-Integrated Biobank (BB-0033-00025), Pasteur Hospital, University Hospital Centre Nice Laboratory of Clinical and Experimental Pathology, Nice, France
| | - Virginie Lespinet-Fabre
- IHU RespirERA, FHU OncoAge, Hospital-Integrated Biobank (BB-0033-00025), Pasteur Hospital, University Hospital Centre Nice Laboratory of Clinical and Experimental Pathology, Nice, France
| | - Salomé Lalvée
- Team 4, Inserm U1081, CNRS 7284, Université Côte d'Azur, Antoine Lacassagne Cancer Center, IRCAN, Nice, France
- IHU RespirERA, FHU OncoAge, Hospital-Integrated Biobank (BB-0033-00025), Pasteur Hospital, University Hospital Centre Nice Laboratory of Clinical and Experimental Pathology, Nice, France
| | - Samantha Goffinet
- Team 4, Inserm U1081, CNRS 7284, Université Côte d'Azur, Antoine Lacassagne Cancer Center, IRCAN, Nice, France
- IHU RespirERA, FHU OncoAge, Hospital-Integrated Biobank (BB-0033-00025), Pasteur Hospital, University Hospital Centre Nice Laboratory of Clinical and Experimental Pathology, Nice, France
| | - Olivier Bordone
- IHU RespirERA, FHU OncoAge, Hospital-Integrated Biobank (BB-0033-00025), Pasteur Hospital, University Hospital Centre Nice Laboratory of Clinical and Experimental Pathology, Nice, France
| | - Elodie Long-Mira
- Team 4, Inserm U1081, CNRS 7284, Université Côte d'Azur, Antoine Lacassagne Cancer Center, IRCAN, Nice, France
- IHU RespirERA, FHU OncoAge, Hospital-Integrated Biobank (BB-0033-00025), Pasteur Hospital, University Hospital Centre Nice Laboratory of Clinical and Experimental Pathology, Nice, France
| | - Sandra Lassalle
- Team 4, Inserm U1081, CNRS 7284, Université Côte d'Azur, Antoine Lacassagne Cancer Center, IRCAN, Nice, France
- IHU RespirERA, FHU OncoAge, Hospital-Integrated Biobank (BB-0033-00025), Pasteur Hospital, University Hospital Centre Nice Laboratory of Clinical and Experimental Pathology, Nice, France
| | - Florent Murcy
- IHU RespirERA, FHU OncoAge, Hospital-Integrated Biobank (BB-0033-00025), Pasteur Hospital, University Hospital Centre Nice Laboratory of Clinical and Experimental Pathology, Nice, France
| | - Guylène Rignol
- Team 4, Inserm U1081, CNRS 7284, Université Côte d'Azur, Antoine Lacassagne Cancer Center, IRCAN, Nice, France
- IHU RespirERA, FHU OncoAge, Hospital-Integrated Biobank (BB-0033-00025), Pasteur Hospital, University Hospital Centre Nice Laboratory of Clinical and Experimental Pathology, Nice, France
| | - Simon Heeke
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Marius Ilie
- IHU RespirERA, FHU OncoAge, Hospital-Integrated Biobank (BB-0033-00025), Pasteur Hospital, University Hospital Centre Nice Laboratory of Clinical and Experimental Pathology, Nice, France
| | - Paul Hofman
- Team 4, Inserm U1081, CNRS 7284, Université Côte d'Azur, Antoine Lacassagne Cancer Center, IRCAN, Nice, France
- IHU RespirERA, FHU OncoAge, Hospital-Integrated Biobank (BB-0033-00025), Pasteur Hospital, University Hospital Centre Nice Laboratory of Clinical and Experimental Pathology, Nice, France
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Hofman P, Calabrese F, Kern I, Adam J, Alarcão A, Alborelli I, Anton NT, Arndt A, Avdalyan A, Barberis M, Bégueret H, Bisig B, Blons H, Boström P, Brcic L, Bubanovic G, Buisson A, Caliò A, Cannone M, Carvalho L, Caumont C, Cayre A, Chalabreysse L, Chenard MP, Conde E, Copin MC, Côté JF, D'Haene N, Dai HY, de Leval L, Delongova P, Denčić-Fekete M, Fabre A, Ferenc F, Forest F, de Fraipont F, Garcia-Martos M, Gauchotte G, Geraghty R, Guerin E, Guerrero D, Hernandez S, Hurník P, Jean-Jacques B, Kashofer K, Kazdal D, Lantuejoul S, Leonce C, Lupo A, Malapelle U, Matej R, Merlin JL, Mertz KD, Morel A, Mutka A, Normanno N, Ovidiu P, Panizo A, Papotti MG, Parobkova E, Pasello G, Pauwels P, Pelosi G, Penault-Llorca F, Picot T, Piton N, Pittaro A, Planchard G, Poté N, Radonic T, Rapa I, Rappa A, Roma C, Rot M, Sabourin JC, Salmon I, Prince SS, Scarpa A, Schuuring E, Serre I, Siozopoulou V, Sizaret D, Smojver-Ježek S, Solassol J, Steinestel K, Stojšić J, Syrykh C, Timofeev S, Troncone G, Uguen A, Valmary-Degano S, Vigier A, Volante M, Wahl SGF, Stenzinger A, Ilié M. Real-world EGFR testing practices for non-small-cell lung cancer by thoracic pathology laboratories across Europe. ESMO Open 2023; 8:101628. [PMID: 37713929 PMCID: PMC10594022 DOI: 10.1016/j.esmoop.2023.101628] [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: 04/13/2023] [Revised: 06/14/2023] [Accepted: 08/02/2023] [Indexed: 09/17/2023] Open
Abstract
BACKGROUND Testing for epidermal growth factor receptor (EGFR) mutations is an essential recommendation in guidelines for metastatic non-squamous non-small-cell lung cancer, and is considered mandatory in European countries. However, in practice, challenges are often faced when carrying out routine biomarker testing, including access to testing, inadequate tissue samples and long turnaround times (TATs). MATERIALS AND METHODS To evaluate the real-world EGFR testing practices of European pathology laboratories, an online survey was set up and validated by the Pulmonary Pathology Working Group of the European Society of Pathology and distributed to 64 expert testing laboratories. The retrospective survey focussed on laboratory organisation and daily EGFR testing practice of pathologists and molecular biologists between 2018 and 2021. RESULTS TATs varied greatly both between and within countries. These discrepancies may be partly due to reflex testing practices, as 20.8% of laboratories carried out EGFR testing only at the request of the clinician. Many laboratories across Europe still favour single-test sequencing as a primary method of EGFR mutation identification; 32.7% indicated that they only used targeted techniques and 45.1% used single-gene testing followed by next-generation sequencing (NGS), depending on the case. Reported testing rates were consistent over time with no significant decrease in the number of EGFR tests carried out in 2020, despite the increased pressure faced by testing facilities during the COVID-19 pandemic. ISO 15189 accreditation was reported by 42.0% of molecular biology laboratories for single-test sequencing, and by 42.3% for NGS. 92.5% of laboratories indicated they regularly participate in an external quality assessment scheme. CONCLUSIONS These results highlight the strong heterogeneity of EGFR testing that still occurs within thoracic pathology and molecular biology laboratories across Europe. Even among expert testing facilities there is variability in testing capabilities, TAT, reflex testing practice and laboratory accreditation, stressing the need to harmonise reimbursement technologies and decision-making algorithms in Europe.
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Affiliation(s)
- P Hofman
- Laboratory of Clinical and Experimental Pathology, FHU OncoAge, Biobank Côte d'Azur BB-0033-00025, Louis Pasteur Hospital, IRCAN, Université Côte d'Azur, Nice, France.
| | - F Calabrese
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - I Kern
- Department of Pathology, University Clinic Golnik, Golnik, Slovenia
| | - J Adam
- Department of Pathology, Groupe Hospitalier Paris Saint-Joseph, Paris, France
| | - A Alarcão
- IAP-PM, Institute of Anatomical and Molecular Pathology, Faculty of Medicine, University of Coimbra, 3004-504 Coimbra, Portugal
| | - I Alborelli
- Department of Pathology, Institute of Medical Genetics and Pathology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - N T Anton
- Department of Genetics, University Hospital Bichat-Claude Bernard, Paris University, Paris, France
| | - A Arndt
- Institute of Pathology and Molecular Pathology, Bundeswehrkrankenhaus Ulm, Oberer Eselsberg 40, 89081 Ulm, Germany
| | - A Avdalyan
- Multidisciplinary Clinical Center "Kommunarka" of the Moscow Health Department, Moscow, Russia
| | - M Barberis
- Oncogenomics Unit, European Institute of Oncology (IEO), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - H Bégueret
- Department of Pathology, University Hospital of Bordeaux, Hôpital Haut-Lévêque, Pessac, France
| | - B Bisig
- Institute of Pathology, Department of Laboratory Medicine and Pathology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - H Blons
- Pharmacogenomics and Molecular Oncology Unit, Biochemistry Department, Assistance Publique-Hopitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France
| | - P Boström
- Department of Pathology, Turku University Hospital, Turku, Finland
| | - L Brcic
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - G Bubanovic
- Laboratory for Molecular Pathology, Department of Pathology, University of Zagreb School of Medicine and University Hospital Centre Zagreb, Zagreb, Croatia
| | - A Buisson
- Department of Biopathology, Centre Léon Bérard, Lyon, France
| | - A Caliò
- Department of Diagnostics and Public Health, Section of Pathology, University and Hospital Trust of Verona, Verona, Italy
| | - M Cannone
- Inter-Hospital Pathology Division, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), MultiMedica, Milan, Italy
| | - L Carvalho
- IAP-PM, Institute of Anatomical and Molecular Pathology, Faculty of Medicine, University of Coimbra, 3004-504 Coimbra, Portugal
| | - C Caumont
- Department of Tumor Biology, University Hospital of Bordeaux, Hospital Haut-Lévêque, Pessac, France
| | - A Cayre
- Department of Biopathology, Jean Perrin Centre, Clermont-Ferrand, France
| | - L Chalabreysse
- Department of Pathology, Groupement Hospitalier Est, Bron, France
| | - M P Chenard
- Department of Pathology, University Hospital of Strasbourg, 67098 Strasbourg, France
| | - E Conde
- Department of Pathology, 12 de Octubre University Hospital, Universidad Complutense de Madrid, Research Institute 12 de Octubre University Hospital (i+12), CIBERONC, Madrid, Spain
| | - M C Copin
- Department of Pathology, Université d'Angers, Centre Hospitalier Universitaire d'Angers, Angers, France
| | - J F Côté
- Department of Pathology, Institut Mutualiste Montsouris, Paris, France
| | - N D'Haene
- Department of Pathology, Erasme Hospital, HUB ULB, Brussels, Belgium
| | - H Y Dai
- Department of Pathology, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
| | - L de Leval
- Institute of Pathology, Department of Laboratory Medicine and Pathology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - P Delongova
- Institute of Molecular and Clinical Pathology and Medical Genetics, Faculty of Medicine, University Hospital Ostrava, Ostrava, Czech Republic
| | | | - A Fabre
- Department of Histopathology, St. Vincent's University Hospital, University College Dublin School of Medicine, Dublin, Ireland
| | - F Ferenc
- Department of Pathology, University of Oradea, Oradea, Romania
| | - F Forest
- Department of Pathology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - F de Fraipont
- Medical Unit of Molecular Genetic (Hereditary Diseases and Oncology), Grenoble University Hospital, Grenoble, France
| | - M Garcia-Martos
- Department of Pathology, Gregorio Marañón General University Hospital, Madrid, Spain
| | - G Gauchotte
- Department of Biopathology, CHRU-ICL, CHRU Nancy, Vandoeuvre-lès-Nancy, France
| | - R Geraghty
- Department of Histopathology, St. Vincent's University Hospital, University College Dublin School of Medicine, Dublin, Ireland
| | - E Guerin
- Department of Molecular Cancer Genetics, Laboratory of Biochemistry and Molecular Biology, University Hospital of Strasbourg, Strasbourg, France
| | - D Guerrero
- Biomedical Research Centre, Navarra Health Service, Pamplona, Navarra, Spain
| | - S Hernandez
- Department of Pathology, 12 de Octubre University Hospital, Universidad Complutense de Madrid, Research Institute 12 de Octubre University Hospital (i+12), CIBERONC, Madrid, Spain
| | - P Hurník
- Institute of Molecular and Clinical Pathology and Medical Genetics, Faculty of Medicine, University Hospital Ostrava, Ostrava, Czech Republic
| | - B Jean-Jacques
- Department of Pathology, CHU de Caen Côte de Nacre, Caen, France
| | - K Kashofer
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - D Kazdal
- Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany; Translational Lung Research Center Heidelberg (TLRC-H), member of the German Center for Lung Research (DZL), Heidelberg, Germany
| | - S Lantuejoul
- Department of Biopathology, Centre Leon Berard Unicancer and Pathology Research Platform, Cancer Research Center of Lyon (CRCL), Lyon, France
| | - C Leonce
- Department of Pathology, Groupement Hospitalier Est, Bron, France
| | - A Lupo
- Department of Pathology, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Université de Paris, Paris, France
| | - U Malapelle
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - R Matej
- Department of Pathology and Molecular Medicine, Thomayer University Hospital, Prague, Czech Republic
| | - J L Merlin
- Department of Biopathology, Institut de Cancérologie de Lorraine, University of Lorraine, Vandoeuvre-Les-Nancy, France
| | - K D Mertz
- Institute of Pathology, Cantonal Hospital Baselland, Liestal, Switzerland
| | - A Morel
- Department of Innate Immunity and Immunotherapy, Institut de Cancérologie de l'Ouest - Centre Paul Papin, Angers, France
| | - A Mutka
- HUSLAB, Department of Pathology, Helsinki University Hospital, Helsinki, Finland
| | - N Normanno
- Cell Biology and Biotherapy Unit, INT-Fondazione Pascale, Via M. Semmola, Naples, Italy
| | - P Ovidiu
- Department of Pathology, University of Oradea, Oradea, Romania
| | - A Panizo
- Department of Pathology, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain
| | - M G Papotti
- Division of Pathology, University Hospital Città Della Salute, Turin, Italy
| | - E Parobkova
- Department of Pathology and Molecular Medicine, Thomayer University Hospital, Prague, Czech Republic
| | - G Pasello
- Division of Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padova, Italy
| | - P Pauwels
- Department of Pathology, University Hospital Antwerp and University of Antwerp, Antwerp, Belgium
| | - G Pelosi
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - F Penault-Llorca
- Department of Pathology, Clermont Auvergne University, "Molecular Imaging and Theranostic Strategies", Center Jean Perrin, Montalembert, Clermont-Ferrand, France
| | - T Picot
- Department of Pathology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - N Piton
- Department of Pathology, Rouen University Hospital, France and Normandie University, UNIROUEN, Inserm U1245, Rouen, France
| | - A Pittaro
- Division of Pathology, University Hospital Città Della Salute, Turin, Italy
| | - G Planchard
- Department of Pathology, CHU de Caen Côte de Nacre, Caen, France
| | - N Poté
- Department of Pathology, Hospital Bichat Bichat, Assistance Publique Hôpitaux de Paris; Université Paris Cité, Paris, France
| | - T Radonic
- Department of Pathology, Amsterdam University Medical Center, VUMC, University of Amsterdam, Amsterdam, Netherlands
| | - I Rapa
- Pathology Unit, San Luigi Hospital, Orbassano Turin, Italy
| | - A Rappa
- Oncogenomics Unit, European Institute of Oncology (IEO), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - C Roma
- Cell Biology and Biotherapy Unit, INT-Fondazione Pascale, Via M. Semmola, Naples, Italy
| | - M Rot
- Department of Pathology, University Clinic Golnik, Golnik, Slovenia
| | - J C Sabourin
- Department of Pathology, Rouen University Hospital, France and Normandie University, UNIROUEN, Inserm U1245, Rouen, France
| | - I Salmon
- Department of Pathology, Erasme Hospital, HUB ULB, Brussels, Belgium; CurePath, Jumet, Belgium
| | - S Savic Prince
- Department of Pathology, Institute of Medical Genetics and Pathology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - A Scarpa
- Department of Diagnostics and Public Health, Section of Pathology, University and Hospital Trust of Verona, Verona, Italy
| | - E Schuuring
- Department of Pathology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - I Serre
- Department of Pathology, Gui de Chauliac Hospital, Montpellier University Medical Center, University of Montpellier, 80 Avenue Augustin Fliche, Montpellier, France
| | - V Siozopoulou
- Department of Pathology, University Hospital Antwerp and University of Antwerp, Antwerp, Belgium
| | - D Sizaret
- Department of Pathology, CHRU Tours - Hôpital Trousseau, Chambray-lès-Tours, France
| | - S Smojver-Ježek
- Division for Pulmonary Cytology, Department of Pathology and Cytology, University Hospital Centre Zagreb, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - J Solassol
- Solid Tumour Laboratory, Pathology and Oncobiology Department, CHU Montpellier, University of Montpellier, Montpellier, France
| | - K Steinestel
- Institute of Pathology and Molecular Pathology, Bundeswehrkrankenhaus Ulm, Oberer Eselsberg 40, 89081 Ulm, Germany
| | - J Stojšić
- Department of Thoracic Pathology, Section of Pathology, University Clinical Centre of Serbia, Belgrade, Serbia
| | - C Syrykh
- Department of Pathology, IUC-T-Oncopole, Toulouse, France
| | - S Timofeev
- Multidisciplinary Clinical Center "Kommunarka" of the Moscow Health Department, Moscow, Russia
| | - G Troncone
- Department of Pathology, University of Oradea, Oradea, Romania
| | - A Uguen
- Department of Pathological Anatomy and Cytology, CHRU de Brest, Brest, France; LBAI, UMR1227, INSERM, University of Brest, CHU de Brest, Brest, France
| | - S Valmary-Degano
- Department of Pathology, Institute for Advanced Biosciences, CHU Grenoble Alpes, Université Grenoble Alpes, Grenoble, France
| | - A Vigier
- Department of Pathology, IUC-T-Oncopole, Toulouse, France
| | - M Volante
- Department of Oncology, University of Turin, San Luigi Hospital, Orbassano, Turin, Italy
| | - S G F Wahl
- Department of Pathology, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
| | - A Stenzinger
- Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany; Translational Lung Research Center Heidelberg (TLRC-H), member of the German Center for Lung Research (DZL), Heidelberg, Germany
| | - M Ilié
- Laboratory of Clinical and Experimental Pathology, FHU OncoAge, Biobank Côte d'Azur BB-0033-00025, Louis Pasteur Hospital, IRCAN, Université Côte d'Azur, Nice, France
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8
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Normanno N, Machado JC, Pescarmona E, Buglioni S, Navarro L, Esposito Abate R, Ferro A, Mensink R, Lambiase M, Lespinet-Fabre V, Calgua B, Jermann PM, Ilié M, Hofman P. European Real-World Assessment of the Clinical Validity of a CE-IVD Panel for Ultra-Fast Next-Generation Sequencing in Solid Tumors. Int J Mol Sci 2023; 24:13788. [PMID: 37762091 PMCID: PMC10531166 DOI: 10.3390/ijms241813788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 09/02/2023] [Accepted: 09/04/2023] [Indexed: 09/29/2023] Open
Abstract
Molecular profiling of solid tumors facilitates personalized, targeted therapeutic interventions. The ability to perform next-generation sequencing (NGS), especially from small tissue samples, in a short turnaround time (TAT) is essential to providing results that enable rapid clinical decisions. This multicenter study evaluated the performance of a CE in vitro diagnostic (IVD) assay, the Oncomine Dx Express Test, on the Ion Torrent Genexus System for detecting DNA and RNA variants in solid tumors. Eighty-two archived formalin-fixed paraffin embedded (FFPE) tissue samples from lung, colorectal, central nervous system, melanoma, breast, gastric, thyroid, and soft tissue cancers were used to assess the presence of single nucleotide variants (SNVs), insertions and deletions (indels), copy number variations (CNVs), gene fusions, and splice variants. These clinical samples were previously characterized at the various academic centers using orthogonal methods. The Oncomine Dx Express Test showed high performance with 100% concordance with previous characterization for SNVs, indels, CNVs, gene fusions, and splice variants. SNVs and indels with allele frequencies as low as 5% were correctly identified. The test detected all the expected ALK, RET, NTRK1, and ROS1 fusion isoforms and MET exon 14-skipping splice variants. The average TAT from extracted nucleic acids to the final variant report was 18.3 h. The Oncomine Dx Express Test in combination with the Ion Torrent Genexus System is a CE-IVD-compliant, performant, and multicenter reproducible method for NGS detection of actionable biomarkers from a range of tumor samples, providing results in a short TAT that could support timely decision- making for targeted therapeutic interventions.
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Affiliation(s)
- Nicola Normanno
- Cell Biology and Biotherapy Unit, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, 80131 Naples, Italy; (N.N.); (R.E.A.)
| | - José Carlos Machado
- Instituto de Investigação e Inovação em Saúde (i3S), University of Porto, 4200-135 Porto, Portugal; (J.C.M.); (A.F.); (R.M.)
- Institute of Molecular Pathology and Immunology, University of Porto (Ipatimup), 4200-135 Porto, Portugal
- Department of Pathology, Faculty of Medicine, University of Porto (FMUP), 4200-319 Porto, Portugal
| | - Edoardo Pescarmona
- I.R.C.C.S. Regina Elena National Cancer Institute, 00144 Rome, Italy; (E.P.); (S.B.)
| | - Simonetta Buglioni
- I.R.C.C.S. Regina Elena National Cancer Institute, 00144 Rome, Italy; (E.P.); (S.B.)
| | - Lara Navarro
- Consorcio Hospital General de Valencia, 46014 Valencia, Spain;
| | - Riziero Esposito Abate
- Cell Biology and Biotherapy Unit, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, 80131 Naples, Italy; (N.N.); (R.E.A.)
| | - Anabela Ferro
- Instituto de Investigação e Inovação em Saúde (i3S), University of Porto, 4200-135 Porto, Portugal; (J.C.M.); (A.F.); (R.M.)
- Institute of Molecular Pathology and Immunology, University of Porto (Ipatimup), 4200-135 Porto, Portugal
| | - Rob Mensink
- Instituto de Investigação e Inovação em Saúde (i3S), University of Porto, 4200-135 Porto, Portugal; (J.C.M.); (A.F.); (R.M.)
- Institute of Molecular Pathology and Immunology, University of Porto (Ipatimup), 4200-135 Porto, Portugal
| | - Matilde Lambiase
- Cell Biology and Biotherapy Unit, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, 80131 Naples, Italy; (N.N.); (R.E.A.)
| | - Virginie Lespinet-Fabre
- Laboratory of Clinical and Experimental Pathology, Biobank BB-0033-00025, FHU OncoAge, IHU RespirERA, CHU de Nice, Université Côte d’Azur, 06000 Nice, France; (V.L.-F.); (M.I.)
| | - Byron Calgua
- Institute of Pathology, University Hospital Basel, 4031 Basel, Switzerland; (B.C.); (P.M.J.)
| | - Philip M. Jermann
- Institute of Pathology, University Hospital Basel, 4031 Basel, Switzerland; (B.C.); (P.M.J.)
| | - Marius Ilié
- Laboratory of Clinical and Experimental Pathology, Biobank BB-0033-00025, FHU OncoAge, IHU RespirERA, CHU de Nice, Université Côte d’Azur, 06000 Nice, France; (V.L.-F.); (M.I.)
| | - Paul Hofman
- Laboratory of Clinical and Experimental Pathology, Biobank BB-0033-00025, FHU OncoAge, IHU RespirERA, CHU de Nice, Université Côte d’Azur, 06000 Nice, France; (V.L.-F.); (M.I.)
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Hofman P. Matched tissue and liquid biopsies for advanced non-small cell lung cancer patients A potentially indispensable complementary approach. Transl Oncol 2023; 35:101735. [PMID: 37413719 PMCID: PMC10366644 DOI: 10.1016/j.tranon.2023.101735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 05/17/2023] [Accepted: 06/27/2023] [Indexed: 07/08/2023] Open
Abstract
The introduction of liquid biopsies (LB) has brought forth a number of therapeutic opportunities into the domain of thoracic oncology. Many of which have been adopted for care of patients presenting with advanced non-squamous non-small cell lung cancer (aNS-NSCLC). For example, one of the most frequent indications to perform a LB in these patients, at least in Europe, is for patients treated with tyrosine kinase inhibitors (TKIs) targeting EGFR and ALK genomic alterations when the tumor progresses. A tissue biopsy (TB) must then be taken, ideally from a site of a tumor that progresses, in particular if the LB does not permit detection of a mechanism of resistance to TKI. A LB from a patient with aNS-NSCLC is recommended before first-line therapy if no tissue and/or cytological material is accessible or if the extracted nucleic acid is insufficient in amount and/or of poor quality. At present a LB and a TB are rarely performed simultaneously before treatment and/or on tumor progression. This complementary/matched testing approach is still controversial but needs to be better evaluated to determine the true benefit to care of patients. This review provides an update on the complementarity of the LB and TB method for care of patients presenting with aNS-NSCLC.
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Affiliation(s)
- Paul Hofman
- Laboratory of Clinical and Experimental Pathology de Pathologie, University Côte d'Azur, FHU OncoAge, Biobank BB-0033-00025, IHU RespireRA, 30 Avenue de la Voie Romaine, 01, Nice 06002 CEDEX, France.
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10
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Silas U, Blüher M, Bosworth Smith A, Saunders R. Fast In-House Next-Generation Sequencing in the Diagnosis of Metastatic Non-small Cell Lung Cancer: A Hospital Budget Impact Analysis. JOURNAL OF HEALTH ECONOMICS AND OUTCOMES RESEARCH 2023; 10:111-118. [PMID: 37389301 PMCID: PMC10306161 DOI: 10.36469/001c.77686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 06/01/2023] [Indexed: 07/01/2023]
Abstract
Background: Targeted therapy for cancer is becoming more frequent as the understanding of the molecular pathogenesis increases. Molecular testing must be done to use targeted therapy. Unfortunately, the testing turnaround time can delay the initiation of targeted therapy. Objective: To investigate the impact of a next-generation sequencing (NGS) machine in the hospital that would allow for in-house NGS testing of metastatic non-small cell lung cancer (mNSCLC) in a US setting. Methods: The differences between 2 hospital pathways were established with a cohort-level decision tree that feeds into a Markov model. A pathway that used in-house NGS (75%) and the use of external laboratories (so-called send-out NGS) (25%), was compared with the standard of exclusively send-out NGS. The model was from the perspective of a US hospital over a 5-year time horizon. All cost input data were in or inflated to 2021 USD. Scenario analysis was done on key variables. Results: In a hospital with 500 mNSCLC patients, the implementation of in-house NGS was estimated to increase the testing costs and the revenue of the hospital. The model predicted a $710 060 increase in testing costs, a $1 732 506 increase in revenue, and a $1 022 446 return on investment over 5 years. The payback period was 15 months with in-house NGS. The number of patients on targeted therapy increased by 3.38%, and the average turnaround time decreased by 10 days when in-house NGS was used. Discussion: Reducing testing turnaround time is a benefit of in-house NGS. It could contribute to fewer mNSCLC patients lost to second opinion and an increased number of patients on targeted therapy. The model outcomes predicted that, over a 5-year period, there would be a positive return on investment for a US hospital. The model reflects a proposed scenario. The heterogeneity of hospital inputs and the cost of send-out NGS means context-specific inputs are needed. Conclusion: Using in-house NGS testing could reduce the testing turnaround time and increase the number of patients on targeted therapy. Additional benefits for the hospital are that fewer patients will be lost to second opinion and that in-house NGS could generate additional revenue.
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Affiliation(s)
- Ubong Silas
- Coreva Scientific GmbH & Co. KG, Königswinter, Germany
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11
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Hofman V, Goffinet S, Bontoux C, Long-Mira E, Lassalle S, Ilié M, Hofman P. A Real-World Experience from a Single Center (LPCE, Nice, France) Highlights the Urgent Need to Abandon Immunohistochemistry for ROS1 Rearrangement Screening of Advanced Non-Squamous Non-Small Cell Lung Cancer. J Pers Med 2023; 13:jpm13050810. [PMID: 37240980 DOI: 10.3390/jpm13050810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 05/04/2023] [Accepted: 05/08/2023] [Indexed: 05/28/2023] Open
Abstract
The detection of ROS1 rearrangements in metastatic non-squamous non-small cell lung carcinoma (NS-NSCLC) permits administration of efficient targeted therapy. Detection is based on a testing algorithm associated with ROS1 immunohistochemistry (IHC) screening followed by ROS1 FISH and/or next generation sequencing (NGS) to confirm positivity. However, (i) ROS1 rearrangements are rare (1-2% of NS-NSCLC), (ii) the specificity of ROS1 IHC is not optimal, and (iii) ROS1 FISH is not widely available, making this algorithm challenging to interpret time-consuming. We evaluated RNA NGS, which was used as reflex testing for ROS1 rearrangements in NS-NSCLC with the aim of replacing ROS1 IHC as a screening method. ROS1 IHC and RNA NGS were prospectively performed in 810 NS-NSCLC. Positive results were analyzed by ROS1 FISH. ROS1 IHC was positive in 36/810 (4.4%) cases that showed variable staining intensity while NGS detected ROS1 rearrangements in 16/810 (1.9%) cases. ROS1 FISH was positive in 15/810 (1.8%) of ROS1 IHC positive cases and in all positive ROS1 NGS cases. Obtaining both ROS1 IHC and ROS1 FISH reports took an average of 6 days, while obtaining ROS1 IHC and RNA NGS reports took an average of 3 days. These results showed that systematic screening for the ROS1 status using IHC must be replaced by NGS reflex testing.
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Affiliation(s)
- Véronique Hofman
- Laboratory of Clinical and Experimental Pathology, University Côte d'Azur, FHU OncoAge, Pasteur Hospital, 06000 Nice, France
- Hospital-Integrated Biobank (BB-0033-00025), Pasteur Hospital, 06000 Nice, France
- Team 4, IRCAN Inserm U1081, CNRS 7284, Université Côte d'Azur, 06100 Nice, France
| | - Samantha Goffinet
- Laboratory of Clinical and Experimental Pathology, University Côte d'Azur, FHU OncoAge, Pasteur Hospital, 06000 Nice, France
- Hospital-Integrated Biobank (BB-0033-00025), Pasteur Hospital, 06000 Nice, France
| | - Christophe Bontoux
- Laboratory of Clinical and Experimental Pathology, University Côte d'Azur, FHU OncoAge, Pasteur Hospital, 06000 Nice, France
- Hospital-Integrated Biobank (BB-0033-00025), Pasteur Hospital, 06000 Nice, France
- Team 4, IRCAN Inserm U1081, CNRS 7284, Université Côte d'Azur, 06100 Nice, France
| | - Elodie Long-Mira
- Laboratory of Clinical and Experimental Pathology, University Côte d'Azur, FHU OncoAge, Pasteur Hospital, 06000 Nice, France
- Hospital-Integrated Biobank (BB-0033-00025), Pasteur Hospital, 06000 Nice, France
- Team 4, IRCAN Inserm U1081, CNRS 7284, Université Côte d'Azur, 06100 Nice, France
| | - Sandra Lassalle
- Laboratory of Clinical and Experimental Pathology, University Côte d'Azur, FHU OncoAge, Pasteur Hospital, 06000 Nice, France
- Hospital-Integrated Biobank (BB-0033-00025), Pasteur Hospital, 06000 Nice, France
- Team 4, IRCAN Inserm U1081, CNRS 7284, Université Côte d'Azur, 06100 Nice, France
| | - Marius Ilié
- Laboratory of Clinical and Experimental Pathology, University Côte d'Azur, FHU OncoAge, Pasteur Hospital, 06000 Nice, France
- Hospital-Integrated Biobank (BB-0033-00025), Pasteur Hospital, 06000 Nice, France
- Team 4, IRCAN Inserm U1081, CNRS 7284, Université Côte d'Azur, 06100 Nice, France
| | - Paul Hofman
- Laboratory of Clinical and Experimental Pathology, University Côte d'Azur, FHU OncoAge, Pasteur Hospital, 06000 Nice, France
- Hospital-Integrated Biobank (BB-0033-00025), Pasteur Hospital, 06000 Nice, France
- Team 4, IRCAN Inserm U1081, CNRS 7284, Université Côte d'Azur, 06100 Nice, France
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12
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Ilié M, Hofman V, Bontoux C, Goffinet S, Benzaquen J, Heeke S, Boutros J, Lassalle S, Long-Mira E, Zahaf K, Lalvée S, Lespinet-Fabre V, Bordone O, Tanga V, Gómez-Caro A, Cohen C, Berthet JP, Marquette CH, Hofman P. Lack of correlation between MET and PD-L1 expression in non-small cell lung cancer revealed by comparative study of matched biopsies and surgical resection samples. Lung Cancer 2023; 181:107230. [PMID: 37150140 DOI: 10.1016/j.lungcan.2023.107230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 04/24/2023] [Accepted: 04/30/2023] [Indexed: 05/09/2023]
Abstract
INTRODUCTION Both MET expression and the PD-L1 tumor proportion score (TPS) are companion diagnostics for treatment of advanced non-small cell lung carcinoma (aNSCLC) patients. We evaluated the rate of correlation between MET expression and the PD-L1 TPS in matched biopsies and surgically resected specimens from NSCLC patients. PATIENTS AND METHODS This retrospective analysis assessed the prevalence and correlation between MET expression (SP44 clone) and the PD-L1 TPS (22C3 clone) by immunohistochemistry together with molecular alterations determined by targeted next-generation sequencing in matched lung biopsy and surgically lung resected specimens from 70 patients with NSCLC. RESULTS The study found a significant correlation between the MET H-score in surgical samples and matched biopsies (P-value < 0.0001), as well as between the PD-L1 TPS in paired biopsies and surgical samples (P-value < 0.0001). However, there was no significant correlation between the MET H-score or expression subgroups and the PD-L1 TPS in both types of paired samples (P-value = 0.47, and P-value = 0.90). The MET H-score was significantly higher in adenocarcinoma compared to squamous cell carcinoma (P-value < 0.0001). A mutational analysis showed that the MET H-score was significantly higher in NSCLC cases with targetable molecular alterations (P-value = 0.0095), while no significant correlation was found for the PD-L1 TPS. CONCLUSIONS Our study found no significant correlation between PD-L1 and MET expression in samples from NSCLC patients, highlighting the importance of personalized treatment strategies based on individual expression profiles. These findings provide valuable insight into the development of effective immunotherapy and targeted therapy for NSCLC patients.
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Affiliation(s)
- Marius Ilié
- Laboratory of Clinical and Experimental Pathology, Hôpital Pasteur, Centre Hospitalier Universitaire de Nice, Université Côte d'Azur, Nice, France; Hospital-integrated Biobank (BB-0033-00025), Hôpital Pasteur, Nice, France; FHU OncoAge, Hôpital Pasteur, Centre Hospitalier Universitaire de Nice, Université Côte d'Azur, Nice, France; Team 4, Inserm U1081, CNRS UMR 7413, Institute for Research on Cancer and Aging, Nice, France
| | - Véronique Hofman
- Laboratory of Clinical and Experimental Pathology, Hôpital Pasteur, Centre Hospitalier Universitaire de Nice, Université Côte d'Azur, Nice, France; Hospital-integrated Biobank (BB-0033-00025), Hôpital Pasteur, Nice, France; FHU OncoAge, Hôpital Pasteur, Centre Hospitalier Universitaire de Nice, Université Côte d'Azur, Nice, France; Team 4, Inserm U1081, CNRS UMR 7413, Institute for Research on Cancer and Aging, Nice, France
| | - Christophe Bontoux
- Laboratory of Clinical and Experimental Pathology, Hôpital Pasteur, Centre Hospitalier Universitaire de Nice, Université Côte d'Azur, Nice, France
| | - Samantha Goffinet
- Laboratory of Clinical and Experimental Pathology, Hôpital Pasteur, Centre Hospitalier Universitaire de Nice, Université Côte d'Azur, Nice, France
| | - Jonathan Benzaquen
- FHU OncoAge, Hôpital Pasteur, Centre Hospitalier Universitaire de Nice, Université Côte d'Azur, Nice, France; Team 4, Inserm U1081, CNRS UMR 7413, Institute for Research on Cancer and Aging, Nice, France; Department of Pulmonary Medicine and Thoracic Oncology, Centre Hospitalier Universitaire de Nice, Université Côte d'Azur, Nice, France
| | - Simon Heeke
- Department of Thoracic/Head and Neck Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Jacques Boutros
- FHU OncoAge, Hôpital Pasteur, Centre Hospitalier Universitaire de Nice, Université Côte d'Azur, Nice, France; Department of Pulmonary Medicine and Thoracic Oncology, Centre Hospitalier Universitaire de Nice, Université Côte d'Azur, Nice, France
| | - Sandra Lassalle
- Laboratory of Clinical and Experimental Pathology, Hôpital Pasteur, Centre Hospitalier Universitaire de Nice, Université Côte d'Azur, Nice, France; Hospital-integrated Biobank (BB-0033-00025), Hôpital Pasteur, Nice, France; FHU OncoAge, Hôpital Pasteur, Centre Hospitalier Universitaire de Nice, Université Côte d'Azur, Nice, France; Team 4, Inserm U1081, CNRS UMR 7413, Institute for Research on Cancer and Aging, Nice, France
| | - Elodie Long-Mira
- Laboratory of Clinical and Experimental Pathology, Hôpital Pasteur, Centre Hospitalier Universitaire de Nice, Université Côte d'Azur, Nice, France; Hospital-integrated Biobank (BB-0033-00025), Hôpital Pasteur, Nice, France; FHU OncoAge, Hôpital Pasteur, Centre Hospitalier Universitaire de Nice, Université Côte d'Azur, Nice, France; Team 4, Inserm U1081, CNRS UMR 7413, Institute for Research on Cancer and Aging, Nice, France
| | - Katia Zahaf
- Laboratory of Clinical and Experimental Pathology, Hôpital Pasteur, Centre Hospitalier Universitaire de Nice, Université Côte d'Azur, Nice, France
| | - Salomé Lalvée
- Laboratory of Clinical and Experimental Pathology, Hôpital Pasteur, Centre Hospitalier Universitaire de Nice, Université Côte d'Azur, Nice, France
| | - Virginie Lespinet-Fabre
- Laboratory of Clinical and Experimental Pathology, Hôpital Pasteur, Centre Hospitalier Universitaire de Nice, Université Côte d'Azur, Nice, France
| | - Olivier Bordone
- Laboratory of Clinical and Experimental Pathology, Hôpital Pasteur, Centre Hospitalier Universitaire de Nice, Université Côte d'Azur, Nice, France
| | - Virginie Tanga
- Hospital-integrated Biobank (BB-0033-00025), Hôpital Pasteur, Nice, France
| | - Abel Gómez-Caro
- Department of Thoracic Surgery, Hôpital Pasteur, Centre Hospitalier Universitaire de Nice, Université Côte d'Azur, Nice, France
| | - Charlotte Cohen
- Department of Thoracic Surgery, Hôpital Pasteur, Centre Hospitalier Universitaire de Nice, Université Côte d'Azur, Nice, France
| | - Jean-Philippe Berthet
- Department of Thoracic Surgery, Hôpital Pasteur, Centre Hospitalier Universitaire de Nice, Université Côte d'Azur, Nice, France
| | - Charles-Hugo Marquette
- FHU OncoAge, Hôpital Pasteur, Centre Hospitalier Universitaire de Nice, Université Côte d'Azur, Nice, France; Team 4, Inserm U1081, CNRS UMR 7413, Institute for Research on Cancer and Aging, Nice, France; Department of Pulmonary Medicine and Thoracic Oncology, Centre Hospitalier Universitaire de Nice, Université Côte d'Azur, Nice, France
| | - Paul Hofman
- Laboratory of Clinical and Experimental Pathology, Hôpital Pasteur, Centre Hospitalier Universitaire de Nice, Université Côte d'Azur, Nice, France; Hospital-integrated Biobank (BB-0033-00025), Hôpital Pasteur, Nice, France; FHU OncoAge, Hôpital Pasteur, Centre Hospitalier Universitaire de Nice, Université Côte d'Azur, Nice, France; Team 4, Inserm U1081, CNRS UMR 7413, Institute for Research on Cancer and Aging, Nice, France.
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13
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Bironzo P, Pepe F, Russo G, Pisapia P, Gragnano G, Aquino G, Bessi S, Buglioni S, Bartoccini F, Ferrero G, Bresciani MA, Francia di Celle P, Sibona F, Giusti A, Movilia A, Farioli RM, Santoro A, Salemi D, Scarpino S, Galafate D, Tommasi S, Lacalamita R, Seminati D, Sajjadi E, Novello S, Pagni F, Troncone G, Malapelle U. An Italian Multicenter Perspective Harmonization Trial for the Assessment of MET Exon 14 Skipping Mutations in Standard Reference Samples. Diagnostics (Basel) 2023; 13:diagnostics13040629. [PMID: 36832117 PMCID: PMC9955861 DOI: 10.3390/diagnostics13040629] [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: 11/11/2022] [Revised: 01/24/2023] [Accepted: 02/03/2023] [Indexed: 02/11/2023] Open
Abstract
Lung cancer remains the leading cause of cancer deaths worldwide. International societies have promoted the molecular analysis of MET proto-oncogene, receptor tyrosine kinase (MET) exon 14 skipping for the clinical stratification of non-small cell lung cancer (NSCLC) patients. Different technical approaches are available to detect MET exon 14 skipping in routine practice. Here, the technical performance and reproducibility of testing strategies for MET exon 14 skipping carried out in various centers were evaluated. In this retrospective study, each institution received a set (n = 10) of a customized artificial formalin-fixed paraffin-embedded (FFPE) cell line (Custom METex14 skipping FFPE block) that harbored the MET exon 14 skipping mutation (Seracare Life Sciences, Milford, MA, USA), which was previously validated by the Predictive Molecular Pathology Laboratory at the University of Naples Federico II. Each participating institution managed the reference slides according to their internal routine workflow. MET exon 14 skipping was successfully detected by all participating institutions. Molecular analysis highlighted a median Cq cut off of 29.3 (ranging from 27.1 to 30.7) and 2514 (ranging from 160 to 7526) read counts for real-time polymerase chain reaction (RT-PCR) and NGS-based analyses, respectively. Artificial reference slides were a valid tool to harmonize technical workflows in the evaluation of MET exon 14 skipping molecular alterations in routine practice.
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Affiliation(s)
- Paolo Bironzo
- Department of Oncology, S. Luigi Gonzaga Hospital, University of Turin, 10043 Orbassano, Italy
| | - Francesco Pepe
- Department of Public Health, University Federico II of Naples, 80131 Naples, Italy
| | - Gianluca Russo
- Department of Public Health, University Federico II of Naples, 80131 Naples, Italy
| | - Pasquale Pisapia
- Department of Public Health, University Federico II of Naples, 80131 Naples, Italy
| | - Gianluca Gragnano
- Department of Public Health, University Federico II of Naples, 80131 Naples, Italy
| | - Gabriella Aquino
- Department of Pulmonary Oncology, AORN Dei Colli Monaldi, 80131 Naples, Italy
| | - Silvia Bessi
- Departmental Structure of Oncological Molecular Pathology, Oncological Department Azienda USL Toscana Centro, S. Stefano Hospital, 59100 Prato, Italy
| | - Simonetta Buglioni
- Pathology Unit, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy
| | - Federico Bartoccini
- Pathology Unit, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy
| | | | | | - Paola Francia di Celle
- Molecular Pathology, AOU Città della Salute e della Scienza di Torino-Presidio Ospedaliero Molinette, 10126 Turin, Italy
| | - Francesca Sibona
- Molecular Pathology, AOU Città della Salute e della Scienza di Torino-Presidio Ospedaliero Molinette, 10126 Turin, Italy
| | - Andrea Giusti
- ASL Toscana Nord Ovest, Pathology Unit, Centro Polispecialistico “Achille Sicari”, 54033 Carrara, Italy
| | - Alessandra Movilia
- Department of Pathology, ASST Ovest Milanese, Ospedale di Legnano, 20025 Legnano, Italy
| | | | - Alessandra Santoro
- Division of Hematology and Bone Marrow Transplantation, Ospedali Riuniti Villa Sofia-Cervello, 90146 Palermo, Italy
| | - Domenico Salemi
- Division of Hematology and Bone Marrow Transplantation, Ospedali Riuniti Villa Sofia-Cervello, 90146 Palermo, Italy
| | - Stefania Scarpino
- Pathology Unit, Department of Clinical and Molecular Medicine, St. Andrea University Hospital, University of Rome La Sapienza, 00189 Rome, Italy
| | - Dino Galafate
- Pathology Unit, Department of Clinical and Molecular Medicine, St. Andrea University Hospital, University of Rome La Sapienza, 00189 Rome, Italy
| | - Stefania Tommasi
- Molecular Genetics Laboratory, IRCCS Istituto Tumori Giovanni Paolo II, 70124 Bari, Italy
| | - Rosanna Lacalamita
- Molecular Genetics Laboratory, IRCCS Istituto Tumori Giovanni Paolo II, 70124 Bari, Italy
| | - Davide Seminati
- Department of Surgery and Translational Medicine, Section of Pathology, Università degli Studi di Mila-no-Bicocca, 20126 Milan, Italy
| | - Elham Sajjadi
- Department of Oncology and Hemato-Oncology, University of Milan, 20136 Milan, Italy
| | - Silvia Novello
- Department of Oncology, S. Luigi Gonzaga Hospital, University of Turin, 10043 Orbassano, Italy
| | - Fabio Pagni
- Department of Surgery and Translational Medicine, Section of Pathology, Università degli Studi di Mila-no-Bicocca, 20126 Milan, Italy
| | - Giancarlo Troncone
- Department of Public Health, University Federico II of Naples, 80131 Naples, Italy
| | - Umberto Malapelle
- Department of Public Health, University Federico II of Naples, 80131 Naples, Italy
- Correspondence:
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14
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Hofman V, Heeke S, Bontoux C, Chalabreysse L, Barritault M, Bringuier PP, Fenouil T, Benzerdjeb N, Begueret H, Merlio JP, Caumont C, Piton N, Sabourin JC, Evrard S, Syrykh C, Vigier A, Brousset P, Mazieres J, Long-Mira E, Benzaquen J, Boutros J, Allegra M, Tanga V, Lespinet-Fabre V, Salah M, Bonnetaud C, Bordone O, Lassalle S, Marquette CH, Ilié M, Hofman P. Ultrafast Gene Fusion Assessment for Nonsquamous NSCLC. JTO Clin Res Rep 2022; 4:100457. [PMID: 36718140 PMCID: PMC9883235 DOI: 10.1016/j.jtocrr.2022.100457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 12/23/2022] [Accepted: 12/27/2022] [Indexed: 12/31/2022] Open
Abstract
Introduction Gene fusion testing of ALK, ROS1, RET, NTRK, and MET exon 14 skipping mutations is guideline recommended in nonsquamous NSCLC (NS-NSCLC). Nevertheless, assessment is often hindered by the limited availability of tissue and prolonged next-generation sequencing (NGS) testing, which can protract the initiation of a targeted therapy. Therefore, the development of faster gene fusion assessment is critical for optimal clinical decision-making. Here, we compared two ultrafast gene fusion assays (UFGFAs) using NGS (Genexus, Oncomine Precision Assay, Thermo Fisher Scientific) and a multiplex reverse-transcriptase polymerase chain reaction (Idylla, GeneFusion Assay, Biocartis) approach at diagnosis in a retrospective series of 195 NS-NSCLC cases and five extrapulmonary tumors with a known NTRK fusion. Methods A total of 195 NS-NSCLC cases (113 known gene fusions and 82 wild-type tumors) were included retrospectively. To validate the detection of a NTRK fusion, we added five NTRK-positive extrathoracic tumors. The diagnostic performance of the two UFGFAs and standard procedures was compared. Results The accuracy was 92.3% and 93.1% for Idylla and Genexus, respectively. Both systems improved the sensitivity for detection by including a 5'-3' imbalance analysis. Although detection of ROS1, MET exon 14 skipping, and RET was excellent with both systems, ALK fusion detection was reduced with sensitivities of 87% and 88%, respectively. Idylla had a limited sensitivity of 67% for NTRK fusions, in which only an imbalance assessment was used. Conclusions UFGFA using NGS and reverse-transcriptase polymerase chain reaction approaches had an equal level of detection of gene fusion but with some technique-specific limitations. Nevertheless, UFGFA detection in routine clinical care is feasible with both systems allowing faster initiation of therapy and a broad degree of screening.
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Affiliation(s)
- Véronique Hofman
- Laboratory of Clinical and Experimental Pathology, Centre Hospitalier Universitaire de Nice, Université Côte d’Azur, Nice, France,Hospital-Integrated Biobank (BB-0033-00025), Hôpital Pasteur, Nice, France,FHU OncoAge, Hôpital Pasteur, Université Côte d’Azur, Nice, France,Inserm U1081, CNRS UMR 7413, IRCAN, Nice, France
| | - Simon Heeke
- Department of Thoracic/Head & Neck Medical Oncology, the University of Texas, MD Anderson Cancer Center, Houston, Texas
| | - Christophe Bontoux
- Laboratory of Clinical and Experimental Pathology, Centre Hospitalier Universitaire de Nice, Université Côte d’Azur, Nice, France,Hospital-Integrated Biobank (BB-0033-00025), Hôpital Pasteur, Nice, France,FHU OncoAge, Hôpital Pasteur, Université Côte d’Azur, Nice, France,Inserm U1081, CNRS UMR 7413, IRCAN, Nice, France
| | - Lara Chalabreysse
- Department of Pathology, Hospices Civils de Lyon, Groupement Hospitalier Est - HCL, Bron, France, University Claude Bernard, Lyon, France
| | - Marc Barritault
- Department of Pathology, Molecular Biology of Tumors, Hospices Civils de Lyon, Groupement Hospitalier Est - HCL, Bron, France
| | - Pierre Paul Bringuier
- Department of Pathology, Molecular Biology of Tumors, Hospices Civils de Lyon, Groupement Hospitalier Est - HCL, Bron, France
| | - Tanguy Fenouil
- Department of Pathology, Hospices Civils de Lyon, Groupement Hospitalier Est - HCL, Bron, France, University Claude Bernard, Lyon, France
| | - Nazim Benzerdjeb
- Department of Pathology, Hospices Civils de Lyon, Hôpital Lyon Sud, Pierre-Bénite, France, University Claude Bernard, Lyon, France,Department of Cancer Cell Plasticity, Cancer Research Center of Lyon, INSERM U1052, CNRS UMR5286, Lyon, France
| | - Hugues Begueret
- Department of Pathology, Centre Hospitalier Universitaire Bordeaux, Hôpital Haut-Lévêque, Pessac, France
| | - Jean Philippe Merlio
- Department of Histology and Molecular Pathology of Tumors, Centre Hospitalier Universitaire Bordeaux, Pessac, France
| | - Charline Caumont
- Department of Histology and Molecular Pathology of Tumors, Centre Hospitalier Universitaire Bordeaux, Pessac, France
| | - Nicolas Piton
- Department of Pathology and INSERM U1245, CHU de Rouen, Normandie Université, Rouen, France
| | | | - Solène Evrard
- Department of Pathology, IUCT-Oncopole, Toulouse, France
| | | | - Anna Vigier
- Department of Pathology, IUCT-Oncopole, Toulouse, France
| | | | - Julien Mazieres
- Department of Pneumology, CHU Toulouse-Hôpital Larrey, Université Paul Sabatier, Toulouse, France
| | - Elodie Long-Mira
- Laboratory of Clinical and Experimental Pathology, Centre Hospitalier Universitaire de Nice, Université Côte d’Azur, Nice, France,Hospital-Integrated Biobank (BB-0033-00025), Hôpital Pasteur, Nice, France,FHU OncoAge, Hôpital Pasteur, Université Côte d’Azur, Nice, France,Inserm U1081, CNRS UMR 7413, IRCAN, Nice, France
| | - Jonathan Benzaquen
- FHU OncoAge, Hôpital Pasteur, Université Côte d’Azur, Nice, France,Inserm U1081, CNRS UMR 7413, IRCAN, Nice, France,Department of Pulmonary Medicine and Thoracic Oncology, Centre Hospitalier Universitaire de Nice, Université Côte d’Azur, Nice, France
| | - Jacques Boutros
- FHU OncoAge, Hôpital Pasteur, Université Côte d’Azur, Nice, France,Inserm U1081, CNRS UMR 7413, IRCAN, Nice, France,Department of Pulmonary Medicine and Thoracic Oncology, Centre Hospitalier Universitaire de Nice, Université Côte d’Azur, Nice, France
| | - Maryline Allegra
- Hospital-Integrated Biobank (BB-0033-00025), Hôpital Pasteur, Nice, France
| | - Virginie Tanga
- Hospital-Integrated Biobank (BB-0033-00025), Hôpital Pasteur, Nice, France
| | - Virginie Lespinet-Fabre
- Laboratory of Clinical and Experimental Pathology, Centre Hospitalier Universitaire de Nice, Université Côte d’Azur, Nice, France
| | - Myriam Salah
- Hospital-Integrated Biobank (BB-0033-00025), Hôpital Pasteur, Nice, France
| | | | - Olivier Bordone
- Laboratory of Clinical and Experimental Pathology, Centre Hospitalier Universitaire de Nice, Université Côte d’Azur, Nice, France
| | - Sandra Lassalle
- Laboratory of Clinical and Experimental Pathology, Centre Hospitalier Universitaire de Nice, Université Côte d’Azur, Nice, France,Hospital-Integrated Biobank (BB-0033-00025), Hôpital Pasteur, Nice, France,FHU OncoAge, Hôpital Pasteur, Université Côte d’Azur, Nice, France,Inserm U1081, CNRS UMR 7413, IRCAN, Nice, France
| | - Charles-Hugo Marquette
- FHU OncoAge, Hôpital Pasteur, Université Côte d’Azur, Nice, France,Inserm U1081, CNRS UMR 7413, IRCAN, Nice, France,Department of Pulmonary Medicine and Thoracic Oncology, Centre Hospitalier Universitaire de Nice, Université Côte d’Azur, Nice, France
| | - Marius Ilié
- Laboratory of Clinical and Experimental Pathology, Centre Hospitalier Universitaire de Nice, Université Côte d’Azur, Nice, France,Hospital-Integrated Biobank (BB-0033-00025), Hôpital Pasteur, Nice, France,FHU OncoAge, Hôpital Pasteur, Université Côte d’Azur, Nice, France,Inserm U1081, CNRS UMR 7413, IRCAN, Nice, France
| | - Paul Hofman
- Laboratory of Clinical and Experimental Pathology, Centre Hospitalier Universitaire de Nice, Université Côte d’Azur, Nice, France,Hospital-Integrated Biobank (BB-0033-00025), Hôpital Pasteur, Nice, France,FHU OncoAge, Hôpital Pasteur, Université Côte d’Azur, Nice, France,Inserm U1081, CNRS UMR 7413, IRCAN, Nice, France,Corresponding author. Address for correspondence: Paul Hofman, MD, PhD, Laboratoire de Pathologie Clinique et Expérimentale, Centre Hospitalier Universitaire de Nice, Hôpital Pasteur, 30 Voie Romaine, 06000 Nice, France.
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15
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Pujol N, Heeke S, Bontoux C, Boutros J, Ilié M, Hofman V, Marquette CH, Hofman P, Benzaquen J. Molecular Profiling in Non-Squamous Non-Small Cell Lung Carcinoma: Towards a Switch to Next-Generation Sequencing Reflex Testing. J Pers Med 2022; 12:1684. [PMID: 36294823 PMCID: PMC9605324 DOI: 10.3390/jpm12101684] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 10/07/2022] [Accepted: 10/08/2022] [Indexed: 11/05/2022] Open
Abstract
Molecular diagnosis of lung cancer is a constantly evolving field thanks to major advances in precision oncology. The wide range of actionable molecular alterations in non-squamous non-small cell lung carcinoma (NS-NSCLC) and the multiplicity of mechanisms of resistance to treatment resulted in the need for repeated testing to establish an accurate molecular diagnosis, as well as to track disease evolution over time. While assessing the increasing complexity of the molecular composition of tumors at baseline, as well as over time, has become increasingly challenging, the emergence and implementation of next-generation sequencing (NGS) testing has extensively facilitated molecular profiling in NS-NSCLC. In this review, we discuss recent developments in the molecular profiling of NS-NSCLC and how NGS addresses current needs, as well as how it can be implemented to address future challenges in the management of NS-NSCLC.
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Affiliation(s)
- Nina Pujol
- Centre Antoine-Lacassagne, Department of Radiation Oncology, Côte d’Azur University, 06000 Nice, France
| | - Simon Heeke
- Department of Thoracic/Head and Neck Medical Oncology, MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Christophe Bontoux
- Laboratory of Clinical and Experimental Pathology, Côte d’Azur University, Pasteur 1 Hospital, Centre Hospitalier Universitaire de Nice, FHU OncoAge, Biobank BB-0033-00025, 06000 Nice, France
- CNRS UMR 7284, INSERM U1081, Institute of Research on Cancer and Aging, Côte d’Azur University, 06000 Nice, France
| | - Jacques Boutros
- CNRS UMR 7284, INSERM U1081, Institute of Research on Cancer and Aging, Côte d’Azur University, 06000 Nice, France
- Department of Pulmonary Medicine and Thoracic Oncology, Côte d’Azur University, Pasteur 1 Hospital, Centre Hospitalier Universitaire de Nice, FHU OncoAge, 06000 Nice, France
| | - Marius Ilié
- Laboratory of Clinical and Experimental Pathology, Côte d’Azur University, Pasteur 1 Hospital, Centre Hospitalier Universitaire de Nice, FHU OncoAge, Biobank BB-0033-00025, 06000 Nice, France
- CNRS UMR 7284, INSERM U1081, Institute of Research on Cancer and Aging, Côte d’Azur University, 06000 Nice, France
| | - Véronique Hofman
- Laboratory of Clinical and Experimental Pathology, Côte d’Azur University, Pasteur 1 Hospital, Centre Hospitalier Universitaire de Nice, FHU OncoAge, Biobank BB-0033-00025, 06000 Nice, France
- CNRS UMR 7284, INSERM U1081, Institute of Research on Cancer and Aging, Côte d’Azur University, 06000 Nice, France
| | - Charles-Hugo Marquette
- CNRS UMR 7284, INSERM U1081, Institute of Research on Cancer and Aging, Côte d’Azur University, 06000 Nice, France
- Department of Pulmonary Medicine and Thoracic Oncology, Côte d’Azur University, Pasteur 1 Hospital, Centre Hospitalier Universitaire de Nice, FHU OncoAge, 06000 Nice, France
| | - Paul Hofman
- Laboratory of Clinical and Experimental Pathology, Côte d’Azur University, Pasteur 1 Hospital, Centre Hospitalier Universitaire de Nice, FHU OncoAge, Biobank BB-0033-00025, 06000 Nice, France
- CNRS UMR 7284, INSERM U1081, Institute of Research on Cancer and Aging, Côte d’Azur University, 06000 Nice, France
| | - Jonathan Benzaquen
- CNRS UMR 7284, INSERM U1081, Institute of Research on Cancer and Aging, Côte d’Azur University, 06000 Nice, France
- Department of Pulmonary Medicine and Thoracic Oncology, Côte d’Azur University, Pasteur 1 Hospital, Centre Hospitalier Universitaire de Nice, FHU OncoAge, 06000 Nice, France
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16
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Deciphering the Impact of HER2 Alterations on Non-Small-Cell Lung Cancer: From Biological Mechanisms to Therapeutic Approaches. J Pers Med 2022; 12:jpm12101651. [PMID: 36294789 PMCID: PMC9605102 DOI: 10.3390/jpm12101651] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 09/26/2022] [Accepted: 09/29/2022] [Indexed: 11/16/2022] Open
Abstract
Despite the recent increase in the number of types of treatments, non-small-cell lung cancer (NSCLC) remains the major cause of death from cancer worldwide. So, there is an urgent need to develop new therapeutic strategies. The HER2 gene codes for tyrosine kinase receptor whose alterations are known to drive carcinogenesis. HER2 alterations, including amplification, mutations, and overexpression, have been mainly described in breast and gastric cancers, but up to 4% of NSCLC harbor actionable HER2 mutations. HER2-targeted therapy for NSCLC with trastuzumab, pertuzumab, and trastuzumab emtansine has failed to demonstrate an improvement in survival. Nevertheless, recent data from phase II trials have shed light on promising specific therapies for HER2-mutant NSCLC such as trastuzumab deruxtecan. Herein, we aimed to provide an updated review on the biology, epidemiology, molecular testing, and therapeutic strategies for NSCLC with HER2 molecular alterations.
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17
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Hofman P, Calin GA, Mani SA, Bontoux C, Ilié M, Wistuba II. The Third Joint Meeting on Lung Cancer of the FHU OncoAge (University Côte d'Azur, Nice, France) and the University of Texas MD Anderson Cancer Center (Houston, TX, USA). Understanding New Therapeutic Options and Promising Predictive Biomarkers for Lung Cancer Patients. Cancers (Basel) 2022; 14:cancers14174327. [PMID: 36077862 PMCID: PMC9454909 DOI: 10.3390/cancers14174327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 08/30/2022] [Indexed: 11/17/2022] Open
Affiliation(s)
- Paul Hofman
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, Université Côte d’Azur, 06000 Nice, France
- Biobank-Related Hospital (BB-0033-00025), Pasteur Hospital, 06000 Nice, France
- FHU OncoAge, Pasteur Hospital, Université Côte d’Azur, 06000 Nice, France
- Inserm U1081, CNRS UMR 7413, IRCAN, 06100 Nice, France
- Correspondence:
| | - George A. Calin
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Sandurai A. Mani
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Christophe Bontoux
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, Université Côte d’Azur, 06000 Nice, France
- Biobank-Related Hospital (BB-0033-00025), Pasteur Hospital, 06000 Nice, France
- FHU OncoAge, Pasteur Hospital, Université Côte d’Azur, 06000 Nice, France
- Inserm U1081, CNRS UMR 7413, IRCAN, 06100 Nice, France
| | - Marius Ilié
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, Université Côte d’Azur, 06000 Nice, France
- Biobank-Related Hospital (BB-0033-00025), Pasteur Hospital, 06000 Nice, France
- FHU OncoAge, Pasteur Hospital, Université Côte d’Azur, 06000 Nice, France
- Inserm U1081, CNRS UMR 7413, IRCAN, 06100 Nice, France
| | - Ignacio I. Wistuba
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
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