Scheffler, Matthias, Wiesweg, Marcel, Michels, Sebastian, Nogova, Lucia, Kron, Anna, Herold, Thomas, Scheel, Andreas H., Metzenmacher, Martin, Eberhardt, Wilfried E., Reis, Henning ORCID: 0000-0003-1373-5295, Fassunke, Jana, Darwiche, Kaid ORCID: 0000-0003-0681-1325, Aigner, Clemens, Schaufler, Diana, Riedel, Richard, Fischer, Rieke, Koleczko, Sophia, Schildhaus, Hans-Ulrich, Merkelbach-Bruse, Sabine, Schmid, Kurt W., Buettner, Reinhard, Wolf, Juergen and Schuler, Martin (2022). Rebiopsy in advanced non-small cell lung cancer, clinical relevance and prognostic implications. Lung Cancer, 168. S. 10 - 21. CLARE: ELSEVIER IRELAND LTD. ISSN 1872-8332

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Abstract

Introduction: Rebiopsies of non-small cell lung cancers (NSCLC) are mainly performed to (i) cover the evolution of potentially amenable resistance mechanisms against a targeted therapy, and (ii) to identify new therapeutic targets which were not detected in the initial diagnostic biopsy. Comprehensive systematic analyses evaluating the value of rebiopsies are missing. Methods: Clinical databases from two large comprehensive cancer center networks were queried following pre specified criteria to identify prospectively entered NSCLC cases with at least one rebiopsy at disease progression. Clinicopathological and biomarker findings including multigene sequencing were correlated with clinical outcomes. Results: From a total of 17,477 stage IV NSCLC patients, a cohort of 403 evaluable patients undergoing at least one rebiopsy of a primary tumor or metastasis was retrieved. Changes in biomarker profiles as compared to baseline were observed in 48.9%. In 31.3% of cases, findings of potential therapeutic relevance were revealed, including 18 patients (4.4%) with a targetable marker only detected at rebiopsy. New findings were more frequent (greater than50%) in NSCLC with EGFR/ALK/ROS1 alterations, including mutations of the dominant oncogene, TP53 mutations, and MET or ERBB2 amplifications. Patients undergoing rebiopsy exhibited superior overall survival compared to a control group, irrespective of presence (HR 0.28) or absence (HR 0.20, both p < 0.001) of a therapeutically targetable aberration. Conclusions: Rebiopsies at progression of advanced NSCLC are strongly supported by a high rate of clinically relevant findings. Current clinical practice selects a patient population with exceptional outcomes, which merits further characterization.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Scheffler, MatthiasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wiesweg, MarcelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Michels, SebastianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Nogova, LuciaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kron, AnnaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Herold, ThomasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Scheel, Andreas H.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Metzenmacher, MartinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Eberhardt, Wilfried E.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Reis, HenningUNSPECIFIEDorcid.org/0000-0003-1373-5295UNSPECIFIED
Fassunke, JanaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Darwiche, KaidUNSPECIFIEDorcid.org/0000-0003-0681-1325UNSPECIFIED
Aigner, ClemensUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schaufler, DianaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Riedel, RichardUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fischer, RiekeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Koleczko, SophiaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schildhaus, Hans-UlrichUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Merkelbach-Bruse, SabineUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schmid, Kurt W.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Buettner, ReinhardUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wolf, JuergenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schuler, MartinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-679990
DOI: 10.1016/j.lungcan.2022.04.006
Journal or Publication Title: Lung Cancer
Volume: 168
Page Range: S. 10 - 21
Date: 2022
Publisher: ELSEVIER IRELAND LTD
Place of Publication: CLARE
ISSN: 1872-8332
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
ACQUIRED-RESISTANCE; EGFR MUTATION; SQUAMOUS-CELL; OPEN-LABEL; CRIZOTINIB; INHIBITORS; AZD9291; OSIMERTINIB; MULTICENTER; AFATINIBMultiple languages
Oncology; Respiratory SystemMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/67999

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