Targeted Therapy Management in NSCLC Patients Using Cytology: Experience from a Tertiary Care Cancer Center
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SHORT COMMUNICATION
Targeted Therapy Management in NSCLC Patients Using Cytology: Experience from a Tertiary Care Cancer Center Vidya H. Veldore1 • Shekar Patil2 • Shilpa Prabhudesai1 • C. T. Satheesh2 • H. P. Shashidhara2 • Naveen Krishnamoorthy1 • D. Hazarika1 • R. Tejaswi1 Ankita Prabhudev1 • Radheshyam Naik2 • Raghavendra M. Rao2,3 • B. S. Ajai Kumar1,2,3
•
Ó Springer International Publishing Switzerland 2015
Abstract Background Although biopsy is the gold standard for diagnosis, cytological material has often been used to assist in making a pathologic diagnosis as well as for molecular testing in certain cancers such as in the lung, cervix, and head/neck. Objective Our objective is to share experience from our institution in the use of cytological material in screening for epidermal growth factor receptor (EGFR) mutations in a subset of patients with non-small cell lung cancer (NSCLC). Methods Fine needle aspirates, pleural effusion, cell blocks of 223 NSCLC patients, where cytology suggested malignancy were screened for EGFR mutation in exons 18–21 using ScorpionÒ ARMS real-time polymerase chain reaction (PCR) technology. Results Overall, EGFR mutation was seen in 43.5 % of study samples. Deletions were highest in exon 19 (27.2 %), followed by exon 21 (15.5 %), exon 18 (5.3 %), and exon 20 (1.9 %). Chi-squared analysis revealed a significant correlation for mutation status in women compared with
men (v2 = 5.88, p = 0.02), with exon 19 mutation predominating (v2 = 5.66, p = 0.02). Conclusion Our results demonstrate the successful use of cytology material for molecular testing in a subset of NSCLC patients to direct their treatment.
Key Points This study demonstrates the optimal use of cytological material for epidermal growth factor receptor (EGFR) mutation analysis for targeted therapy management in patients with non-small cell lung cancer (NSCLC). The mutation percentage is similar to that reported in earlier studies from India and other Asian countries where tissue biopsy was provided as sampling material. The highly sensitive ScorpionÒ ARMS mutation detection method has been shown to be sufficiently robust to reliably detect EGFR activating mutations from cytology specimens.
This work was conducted in the Department of Molecular Pathology, Triesta Reference Laboratory, HCG Oncology Hospitals, HCG Enterprises Ltd, Bangalore—560 027, India. & Vidya H. Veldore [email protected]; [email protected] 1
Triesta Reference Laboratory, Triesta Sciences, A Unit of Health Care Global Enterprises Ltd., 8, P Kalinga Rao Road, HCG Tower 1, SR Nagar, Bangalore 560 027, India
2
HCG Oncology Hospitals, Bangalore, India
3
Centre for Academics and Research, HCG Foundation, Bangalore 560 027, India
1 Introduction Lung cancer is one of the major cancer burdens worldwide [1]. A lack of efficient screening methods results in presentation of the disease at late stages, leading to very high mortality rates. Core needle/Tru-cut biopsy is the gold standard method used for confirmatory diagnosis of lung cancer.
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