Abstract 333P
Background
Endoscopic ultrasound-guided tissue acquisition (EUS-TA) has been instrumental in the diagnosis of pancreatic ductal adenocarcinoma (PDAC), and EUS-TA samples increasingly are being considered for comprehensive genome profiling (CGP) to facilitate precision medicine. We performed a systematic review and meta-analysis to evaluate the feasibility and clinical utility of EUS-TA for CGP in PDAC.
Methods
We conducted a comprehensive systematic literature search in PubMed, EMBASE, and the Cochrane Library through October 2023. The outcomes of interest were the success rate of sequencing, detection rates of four major driver and actionable genes, and concordance rates with other samples or methods.
Results
A total of 23 studies was included in the final analysis. The pooled sequencing success rate was 83.9% [95% confidence interval (CI): 75.8–89.7%]. There was no significant difference in the sequencing success rates between fine needle aspiration and biopsy (odds ratio 1.77, 95% CI 0.70-4.47). In meta-regression analysis, minimum DNA requirement for CGP significantly affected the sequencing success rate. The pooled mutation rates for K-ras and of potentially actionable mutations was 86.4% (95% CI 83.6–88.8) and 17.7% (95% CI 12.8–23.8), respectively. The pooled concordance rate in CGP between EUS-guided samples and surgical specimens was 81.6% (95% CI 68.2–90.1).
Conclusions
A comprehensive evaluation of the PDAC mutational profile using small samples obtained through EUS-TA demonstrated its feasibility in clinical practice. About 18% of patients who underwent CGP harbored potentially actionable mutations, offering the prospect of personalized treatment.
Legal entity responsible for the study
Seung Bae Yoon.
Funding
Has not received any funding.
Disclosure
The author has declared no conflicts of interest.