Method of Tissue Acquisition Affects Success of Comprehensive Genomic Profiling in Lung Cancer.

CONTEXT.­: Multiple procedural techniques can be used to obtain tissue to create a formalin-fixed, paraffin-embedded specimen for comprehensive genomic profiling (CGP) in lung cancer. The literature is mixed on whether the procedure affects CGP success. OBJECTIVE.­: To examine whether biopsy procedure affects lung cancer CGP success. DESIGN.­: This was a cross-sectional study of all patients with lung cancer whose specimens were submitted for CGP between January and February 2020. Multiple quality control metrics were used to determine whether cases were successfully profiled. RESULTS.­: In all, 3312 samples were identified. Overall, 67.5% (2236 of 3312) of samples were obtained from biopsies, 13.0% (432 of 3312) from fine-needle aspirations (FNAs), 9.7% (321 of 3312) from resections, 5.3% (174 of 3312) from fluid cytology cell blocks, and 4.5% (149 of 3312) from bone biopsies. Overall, 70.1% (2321 of 3312) of cases passed CGP, 15.4% (510 of 3312) of cases were released as qualified reports, and 14.5% (481 of 3312) of cases failed CGP. Resection samples were the most likely to be successfully sequenced, failing in only 2.8% (9 of 321) of instances, while fluid cytology specimens were the least likely, failing in 23.0% (40 of 174) of instances. Biopsy (14.5% [324 of 2236]), FNA (18.5% [80 of 432]), and bone biopsy (18.8% [28 of 149]) specimens failed at intermediate frequencies. On multivariate logistic regression analysis of CGP success on specimen type, fluid cytology (odds ratio [OR], 0.08; 95% CI, 0.03-0.19), biopsy (OR, 0.25; 95% CI, 0.11-0.52), FNA (OR, 0.14; 95% CI, 0.06-0.32), and bone biopsy (OR, 0.07; 95% CI, 0.03-0.17) specimens had decreased odds of CGP success relative to resection samples. Among patients with successfully sequenced samples, 48.0% were eligible for at least 1 therapy, based on a companion diagnostic or National Comprehensive Cancer Network biomarker. CONCLUSIONS.­: The method of tissue acquisition was an important preanalytic factor that determined whether a sample would be successfully sequenced and whether a clinically actionable genomic alteration would be detected.

Recommendations for Preventing Child Sexual Abuse in Youth-Serving Organizations: Implications From an Australian Royal Commission Review of the Literature.

Evidence suggests that tens of millions of children and adolescents are involved in youth-serving organizations (YSOs) outside of their homes on a daily basis. Children's involvement with YSOs clearly offers a broad array of emotional, social, and personal development benefits. This involvement can, however, also be associated with a variety of safety risks, including the potential for child sexual abuse (CSA) victimization and the myriad short- and long-term consequences to its victims and their families. Recognizing the significance of CSA within YSOs, the Australian Royal Commission into Institutional Responses to Child Sexual Abuse funded a comprehensive review of the literature on risk and protective factors related to CSA in institutions. This yielded more than 400 primarily research articles from the United States, United Kingdom, and Australia, examining institutional CSA victims, perpetrators, and settings. Findings were provided regarding six specific types of institutional settings, including faith-based, early childhood education, childcare and schools, health care, out-of-home/foster care, and sport. This article is based on the findings of Kaufman and Erooga's comprehensive literature review and Royal Commission findings. It provides a brief review of critical risks associated with CSA victims, perpetrators, and organizational settings, as well as highlights risks particular to specific types of YSOs and risks that are present across these organizations. Optimal prevention directions and strategies are outlined in response to identified patterns of organizational risk. Recommendations for YSO policy enhancements are also provided to complement the article's prevention focus. Finally, suggestions are offered for future research directions to foster the development of an evidence-based foundation for work in this area.