Feasibility of shape-sensing robotic-assisted bronchoscopy for biomarker identification in patients with thoracic malignancies Journal Article
| Authors: | Connolly, J. G.; Kalchiem-Dekel, O.; Tan, K. S.; Dycoco, J.; Chawla, M.; Rocco, G.; Park, B. J.; Lee, R. P.; Beattie, J. A.; Solomon, S. B.; Ziv, E.; Adusumilli, P. S.; Buonocore, D. J.; Husta, B. C.; Jones, D. R.; Baine, M. K.; Bott, M. J. |
| Article Title: | Feasibility of shape-sensing robotic-assisted bronchoscopy for biomarker identification in patients with thoracic malignancies |
| Abstract: | Objective: Molecular diagnostic assays require samples with high nucleic acid content to generate reliable data. Similarly, programmed death-ligand 1 (PD-L1) immunohistochemistry (IHC) requires samples with adequate tumor content. We investigated whether shape-sensing robotic-assisted bronchoscopy (ssRAB) provides adequate samples for molecular and predictive testing. Methods: We retrospectively identified diagnostic samples from a prospectively collected database. Pathologic reports were reviewed to assess adequacy of samples for molecular testing and feasibility of PD-L1 IHC. Tumor cellularity was quantified by an independent pathologist using paraffin-embedded sections. Univariable and multivariable linear regression models were constructed to assess associations between lesion- and procedure-related variables and tumor cellularity. Results: In total, 128 samples were analyzed: 104 primary lung cancers and 24 metastatic lesions. On initial pathologic assessment, ssRAB samples were deemed to be adequate for molecular testing in 84% of cases; on independent review of cellular blocks, median tumor cellularity was 60% (interquartile range, 25%-80%). Hybrid capture-based next-generation sequencing was successful for 25 of 26 samples (96%), polymerase chain reaction-based molecular testing (Idylla; Biocartis) was successful for 49 of 52 samples (94%), and PD-L1 IHC was successful for 61 of 67 samples (91%). Carcinoid and small cell carcinoma histologic subtype and adequacy on rapid on-site evaluation were associated with higher tumor cellularity. Conclusions: The ssRAB platform provided adequate tissue for next-generation sequencing, polymerase chain reaction-based molecular testing, and PD-L1 IHC in >80% of cases. Tumor histology and adequacy on intraoperative cytologic assessment might be associated with sample quality and suitability for downstream assays. © 2022 The American Association for Thoracic Surgery |
| Keywords: | molecular testing; next-generation sequencing; pulmonary nodule; thoracic malignancy; robotic-assisted bronchoscopy |
| Journal Title: | Journal of Thoracic and Cardiovascular Surgery |
| Volume: | 166 |
| ISSN: | 0022-5223 |
| Publisher: | Mosby Elsevier |
| Date Published: | 2023-07-01 |
| Start Page: | 231 |
| End Page: | 240.e2 |
| Language: | English |
| DOI: | 10.1016/j.jtcvs.2022.10.059 |
| PROVIDER: | scopus |
| PMCID: | PMC10209350 |
| PUBMED: | 36621452 |
| DOI/URL: | |
| Notes: | MSK Cancer Center Support Grant (P30 CA008748) acknowledged in PDF and PubMed -- MSK corresponding author is Matthew Bott -- Source: Scopus |
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