Re-biopsy status among non-small cell lung cancer patients in Japan: A retrospective study

Kaname Nosaki, Miyako Satouchi, Takayasu Kurata, Tatsuya Yoshida, Isamu Okamoto, Nobuyuki Katakami, Fumio Imamura, Kaoru Tanaka, Yuki Yamane, Nobuyuki Yamamoto, Terufumi Kato, Katsuyuki Kiura, Hideo Saka, Hiroshige Yoshioka, Kana Watanabe, Keiko Mizuno, Takashi Seto

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Abstract

Objective Disease progression because of acquired resistance is common in advanced or metastatic epidermal growth factor receptor (EGFR)-mutation positive non-small cell lung cancer (NSCLC), despite initial response to EGFR-tyrosine kinase inhibitors (TKIs). In Japan, transbronchial tissue biopsy is the most common sampling method used for re-biopsy to identify patients eligible for treatment. We aimed to investigate the success rate of re-biopsy and re-biopsy status of patients with advanced or metastatic NSCLC completing first-line EGFR-TKI therapy. Patients and methods This was a retrospective, multi-center, Japanese study. The target patients in the study were EGFR mutation-positive NSCLC patients. The primary endpoint was the success rate (number of cases in which tumor cells were detected/total number of re-biopsies performed × 100). Secondary endpoints included differences between the status of the first biopsy and that of the re-biopsy in the same patient population, and the details of cases in which re-biopsy could not be carried out. Re-biopsy-associated complications were also assessed. Results Overall, 395 patients were evaluated (median age 63 years), with adenocarcinoma being the most common tumor type. Re-biopsy was successful in 314 patients (79.5%). Compared with the sampling method at first biopsy, at re-biopsy, the surgical resection rate increased from 1.8% to 7.8%, and percutaneous tissue biopsy increased from 7.6% to 29.1%, suggesting the difficulty of performing re-biopsy. Approximately half of the patients had T790M mutations, which involved a Del19 mutation in 55.6% of patients and an L858R mutation in 43.0%. Twenty-three patients (5.8%) had re-biopsy- associated complications, most commonly pneumothorax. Conclusions Success rate for re-biopsy in this study was approximately 80%. Our study sheds light on the re-biopsy status after disease progression in patients with advanced or metastatic NSCLC. This information is important to improve the selection of patients who may benefit from third-generation TKIs.

Original languageEnglish
Pages (from-to)1-8
Number of pages8
JournalLung Cancer
Volume101
DOIs
Publication statusPublished - Nov 1 2016

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Keywords

  • Epidermal growth factor receptor mutation
  • Non-small cell lung cancer
  • Re-biopsy
  • Resistance
  • T790 M
  • Tyrosine kinase inhibitor

ASJC Scopus subject areas

  • Medicine(all)
  • Oncology
  • Pulmonary and Respiratory Medicine
  • Cancer Research

Cite this

Nosaki, K., Satouchi, M., Kurata, T., Yoshida, T., Okamoto, I., Katakami, N., Imamura, F., Tanaka, K., Yamane, Y., Yamamoto, N., Kato, T., Kiura, K., Saka, H., Yoshioka, H., Watanabe, K., Mizuno, K., & Seto, T. (2016). Re-biopsy status among non-small cell lung cancer patients in Japan: A retrospective study. Lung Cancer, 101, 1-8. https://doi.org/10.1016/j.lungcan.2016.07.007