Suitability of endobronchial ultrasound-guided transbronchial needle aspiration samples for programmed death ligand-1 testing in non-small cell lung cancer, the Bristol experience

To assess EBUS-TBNA biopsy adequacy for ALK, EGFR and PD-L1 testing, we conducted a prospective study of 279 consecutive NSCLC patients referred to a tertiary EBUS-TBNA centre in South West England. One hundred eight-four (62.6%) patients were found to have adenocarcinoma, 83 (28.2%) had squamous cell carcinoma, and 27 (9.2%) were identified as NSCLC-not otherwise specified. EGFR testing was successful in 166 of 168 patients (98.8%), ALK testing in all 115 and PD-L1 testing in 43 of 49 patients (88.2%). Previous EGFR and ALK testing did not affect biopsy PD-L1 testing success. PD-L1 testing failures occurred in three of five (60.0%) of 22G needle biopsies, one of five (20.0%) of 21G needle biopsies and two of 39 (5.1%) of 19G needle biopsies, P = .016. EBUS-TBNA biopsies are mostly suitable for PD-L1 testing. Larger needle size may improve PD-L1 (but not EGFR and ALK) testing success but requires further study in a controlled trial...... READ ARTICLE

Asia-Pacific Journal of Clinical Oncology DOI:10.1111/ajco.13549

Authors: Joanna Hardy, Nidhi Bhatt, Andrew R L Medford

Real-World OutcomesKirk SmithApril 18, 2021ALK p, ceritinib, resistance, lorlatinib, ALK, NSCLC, next generation sequencing, NGS

Identification of a Novel resistance ALK p.(Q1188_L1190del) deletion in a Patient with ALK-rearranged Non–small-cell Lung cancer

Comprehensive genomic profiling is needed to know and then target the genes causing resistance in ALK rearranged patients [ [9] ]. We report one such novel deletion p.(Q1188_L1190del) in the ALK tyrosine kinase domain which responded to Lorlatinib. READ ARTICLE

Cancer Genetics DOI:10.1016/j.cancergen.2021.03.006

Authors: Moushumi Suryavanshi, Krushna Chaudhari, Shrinidhi Nathany, Vineet Talwar

Case StudyKirk SmithApril 4, 2021ALK p, Ceritinib resistance, lorlatinib, ALK, NSCLC, next generation sequencing, NGS