2023 North America Conference on Lung Cancer (NACLC) - Posters and Abstracts-PP01.134 Michelle Shiller NACLC23 Abstract

PP01.134 Michelle Shiller NACLC23 Abstract

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Comprehensive genomic profiling (CGP) is recommended for detecting genomic alterations in advanced stage non-small cell lung cancer (NSCLC). However, there are challenges with tissue quality and quantity requirements for CGP testing, leading to a significant number of cases without interpretable results. In this study, pathologist-driven testing algorithms were used to reflexively perform molecular testing with a quick turnaround time.<br /><br />The study attempted CGP testing on 3,720 NSCLC cases using Pathgroup's Endeavor test, which is a DNA-based panel. Cases were deemed insufficient for CGP testing due to limited tissue, tumor composition, poor tissue quality, low DNA concentration, or poor DNA integrity. Reflex testing included single gene testing for hotspot mutations and fluorescence in situ hybridization (FISH) for rearrangements and copy number variation.<br /><br />Out of the 573 NSCLC patients with insufficient samples for CGP, 295 (51.5%) obtained results from single gene testing, FISH testing, or both. The median turnaround time for these results was 4 business days from the time of CGP failure. Additionally, 460 (80.3%) patients received immunohistochemistry (IHC) results for PD-L1 expression.<br /><br />The ability to perform orthogonal molecular testing in one location provided timely and clinically informative results for patients with reduced risk and cost associated with repeat procedures. This approach maximized tissue stewardship by repurposing tissue and DNA where possible.<br /><br />In conclusion, CGP failure can lead to delayed treatment, repeat procedures, increased cost, and increased patient morbidity. Utilizing pathologist-driven reflex testing algorithms can provide rapid and orthogonal results, addressing these challenges and improving patient outcomes.

Keywords

Comprehensive genomic profiling

non-small cell lung cancer

molecular testing

quick turnaround time

insufficient samples

single gene testing

fluorescence in situ hybridization

immunohistochemistry

orthogonal molecular testing

patient outcomes