WCLC 2025 - Posters & ePosters-EP.05.02 Evaluation of ROSE Utility in Multiplex Gene-Panel Testing Using Samples From EBUS-GS for Lung Cancer

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This multi-center retrospective study investigated the impact of adding rapid on-site evaluation (ROSE) to endobronchial ultrasound-guided sheath bronchoscopy (EBUS-GS) on the diagnostic success rate of multiplex gene-panel testing (MGPT) for lung cancer. MGPT enables simultaneous detection of multiple driver mutations crucial for lung cancer treatment. Obtaining adequate biopsy samples from peripheral pulmonary lesions (PPLs) is challenging, and EBUS-GS is an effective modality. Although ROSE has been known to improve overall diagnostic yield, its effect on MGPT success had not been clearly defined.<br /><br />The study analyzed 89 patients undergoing EBUS-GS and MGPT across two hospitals over four years, excluding those under 18 years old. Inverse probability weighting (IPW) adjusted for confounding factors in the analysis. Logistic regression demonstrated that incorporating ROSE significantly increased MGPT success rates (OR 5.37; p=0.042). Success was defined as obtaining specimens not deemed inadequate by the lab. ROSE likely enhances MGPT success by ensuring adequate sample quality during biopsy.<br /><br />Patient characteristics—including age, sex, smoking history, lesion size, and location—were balanced between ROSE (n=33) and non-ROSE (n=56) groups after IPW adjustment. The procedural time and number of biopsied samples were higher in the ROSE group. MGPT success rate was 93.9% with ROSE versus 75.0% without (p=0.043). Additionally, MGPT success improved significantly between the first and second halves of the study period (p<0.01), possibly reflecting growing experience.<br /><br />Limitations include potential residual selection bias despite IPW adjustment and lack of evaluation for sample quality metrics such as tumor cell count and nucleic acid yield. The benefit of ROSE appeared less pronounced in highly experienced teams.<br /><br />In conclusion, ROSE addition to EBUS-GS significantly improves MGPT success rates by facilitating adequate specimen collection, supporting its use in clinical practice to optimize genetic testing for lung cancer therapy decisions.

Asset Subtitle

Yukihiro Nakamura

Meta Tag

Speaker Yukihiro Nakamura

Topic Pulmonology and Staging

Keywords

Rapid On-Site Evaluation

ROSE

Endobronchial Ultrasound-Guided Sheath Bronchoscopy

EBUS-GS

Multiplex Gene-Panel Testing

MGPT

Lung Cancer

Peripheral Pulmonary Lesions

Biopsy Sample Adequacy

Diagnostic Success Rate