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Trends in histological diagnosis and mutation testing to determine suitability for targeted therapies following percutaneous lung biopsy
EP29170
Trends in histological diagnosis and mutation testing to determine suitability for targeted therapies following percutaneous lung biopsy
Submitted on 15 Sep 2018

William Crawford, Wajid Rafai, Somil Desai, Tara Barton, Maria Tsakok
The University of Oxford Medical School, Royal Berkshire NHS Foundation Trust
This poster was presented at British Institute of Radiology Congress 2018
Poster Views: 177
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Poster Abstract
Image-guided percutaneous lung biopsy is essential for lung cancer diagnosis. There is increased demand for tissue for further histological and genotype analysis with the advent of newer EGFR and ALK mutation-targeted therapies and the recently NICE-approved immune checkpoint inhibitors in non-small cell lung cancer (NSLC). Such analysis refines prognostication and confers further treatment opportunities. The National Lung Cancer Audit (NLCA) defines the standard for pathological confirmation of lung cancer to be >90% and the proportion of patients receiving anticancer treatment to be >60%. No standards yet exist, however, to determine those referred for further mutation analysis and subsequent targeted therapies. This study aimed to determine these trends at our local institution. In 140 lung biopsies performed, 117 (82.98%) were deemed to be adequate for histological analysis. Inadequate sample was due to insufficient tissue (14 biopsies; 60.87%), fragmented samples (7 biopsies; 30.43%) and sampling of necrotic tissue (5 biopsies; 21.74%). In the 117 lung biopsies with adequate tissue for histological analysis, 77 (66.81%) were found to be primary lung malignancy (64.94% adenocarcinoma; 28.57% squamous cell carcinoma; 6.49% small cell carcinoma). 66 (85.71%) samples with adequate tissue for histological analyses were genotyped, 2 (3.03%) were positive for EGFR mutations, 4 (6.06%) were positive for ALK translocations, and 11 (16.67%) were positive for PD-1 expression. A histological diagnosis is achieved in 83% lung biopsies, below the NLCA standards. However, further genotyping is occurring in a high proportion of primary lung malignancy at our institution, increasing targeted treatment options and improving prognostication for these patients.Report abuse »
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