2023 North America Conference on Lung Cancer (NACLC) - Posters and Abstracts-PP01.070 Sylvia Yong NACLC23 Abstract

PP01.070 Sylvia Yong NACLC23 Abstract

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Advancements in treatment modalities for non-small cell lung cancer (NSCLC) have led to improved outcomes, particularly with targeted immunotherapy. This is made possible by identifying therapeutic targets through immunohistochemistry and genomic analysis using next-generation sequencing (NGS). While endobronchial ultrasound (EBUS) has been used to obtain tissue samples from mediastinal lymph nodes for NGS, limited data exists on the use of peripheral nodule biopsy for this purpose. This study aims to evaluate the adequacy of NGS via robotic-assisted bronchoscopy (RB) for diagnosing NSCLC and guiding treatment management.<br /><br />The study reviewed medical records of patients who underwent RB for evaluating peripheral pulmonary nodules at a single center. Inclusion criteria included patients aged 18 or older who were ultimately diagnosed with NSCLC on peripheral lung biopsy. The adequacy of tumor cellularity for NGS and the presence of actionable mutations were evaluated.<br /><br />Out of 56 nodules that were targeted, 73.2% of the procedures were diagnostic and 82.4% of the malignant diagnoses were NSCLC. Among the NSCLC cases where NGS was requested, 88% were sufficient for testing, and 59.1% had actionable mutations detected. Additionally, 80.5% of patients required only one procedure for diagnosis and staging, allowing for a quicker transition to treatment.<br /><br />In the era of targeted immunotherapy and its growing role in neoadjuvant therapy for early-stage NSCLC, it is important to consider diagnostic procedures that can guide management through NGS analysis for targetable mutations. In this study, RB demonstrated potential as a diagnostic modality by assisting with navigation to peripheral pulmonary nodules, performing staging, and obtaining sufficient tissue for targeted therapy in a single procedure. While further research is needed, RB shows promise in providing accurate diagnosis and guiding treatment decisions for NSCLC patients.

Keywords

NSCLC

targeted immunotherapy

immunohistochemistry

genomic analysis

next-generation sequencing

peripheral nodule biopsy

robotic-assisted bronchoscopy

actionable mutations

diagnostic procedures

neoadjuvant therapy