Abstract 1099P
Background
Molecular characterization of tumor samples has become pivotal in the management of patients affected by non-small cell lung cancer (NSCLC), although this process is often time-consuming. Some lung neoplasms are initially detected after hospitalization through the First Aid Department and the performance status of new patients might worsen while molecular analyses are processed. The primary aim of this ongoing study is to evaluate the performance of “up-front” next-generation sequencing (NGS) through liquid biopsy of hospitalized patients with newly detected lung neoplasm in parallel with conventional diagnosis.
Methods
We aim to enroll 30 consecutive patients, irrespective of smoking history, immediately after detection of symptomatic, locally advanced or metastatic lung neoplasm. Liquid biopsy from peripheral blood is performed at baseline, in parallel with conventional biopsy, when feasible. Additionally, liquid biopsies are repeated during treatment and at progression in patients with any molecular alteration at baseline. Oncomine™Lung cfTNA Research Assay or Oncomine™Lung cfDNA panels are employed for processing plasma samples in NGS.
Results
Between January and May 2022, we recruited 18 hospitalized patients. Liquid biopsy NGS identified five EGFR activating mutations, one ALK rearrangement, five KRAS mutations and one ERBB2 mutation. Median time to results of liquid biopsy was 8 days (5-15) compared to 17 (8-34) by conventional biopsy. Liquid biopsy and conventional biopsy were consistent in all cases apart from one patient who was wild type at liquid biopsy and harbored EGFR exon 19 deletion at tissue biopsy. Four patients with actionable oncogenic drivers at liquid biopsy (one ALK rearrangement, two EGFR mutations and one ERBB2 mutation) could not undergo conventional biopsies due to clinical contraindications.
Conclusions
Front-line liquid biopsy might improve the management of symptomatic, hospitalized patients with lung cancer, potentially leading to early start of targeted therapy. Enrollment and longitudinal monitoring of oncogenic drivers with liquid biopsy are ongoing.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Italian Ministry of Health.
Disclosure
G. Rossi, C. Dellepiane: Financial Interests, Personal, Invited Speaker: AstraZeneca, BMS, Roche. C. Genova: Financial Interests, Personal, Invited Speaker: AstraZeneca, BMS, Roche, MSD, Sanofi, Takeda, Thermofisher; Financial Interests, Institutional, Research Grant: Italian Ministry of Health. All other authors have declared no conflicts of interest.