RESUMO
BACKGROUND: Targeted next-generation sequencing (NGS) is recommended to screen actionable genomic alterations (GAs) in patients with non-small-cell lung cancer (NSCLC). We determined the feasibility to detect actionable GAs using TruSight™ Oncology 500 (TSO500) in 200 consecutive patients with NSCLC. MATERIALS AND METHODS: DNA and RNA were sequenced on an Illumina® NextSeq 550 instrument and processed using the TSO500 Docker pipeline. Clinical actionability was defined within the molecular tumour board following European Society for Medical Oncology (ESMO) guidelines for oncogene-addicted NSCLC. Overall survival (OS) was estimated as per the presence of druggable GAs and treatment with targeted therapy. RESULTS: Most patients were males (69.5%) and former or current smokers (86.5%). Median age was 64 years. The most common histological type and tumour stage were lung adenocarcinoma (81%) and stage IV (64%), respectively. Sequencing was feasible in most patients (93.5%) and actionable GAs were found in 26.5% of patients. A high concordance was observed between single-gene testing and TSO500 NGS panel. Patients harbouring druggable GAs and receiving targeted therapy achieved longer OS compared to patients without druggable GAs. Conversely, patients with druggable GAs not receiving targeted therapy had a trend toward shorter OS compared with driver-negative patients. CONCLUSIONS: Hybrid capture sequencing using TSO500 panel is feasible to analyse clinical samples from patients with NSCLC and is an efficient tool for screening actionable GAs.
Assuntos
Adenocarcinoma de Pulmão , Carcinoma Pulmonar de Células não Pequenas , Neoplasias Pulmonares , Masculino , Humanos , Pessoa de Meia-Idade , Feminino , Carcinoma Pulmonar de Células não Pequenas/diagnóstico , Neoplasias Pulmonares/tratamento farmacológico , Estudos de Viabilidade , GenômicaRESUMO
Multidisciplinary care is needed to decide the best therapeutic approach and to provide optimal care to patients with lung cancer (LC). Multidisciplinary teams (MDTs) are optimal strategies for the management of patients with LC and have been associated with better outcomes, such as an increase in quality of life and survival. The Spanish Lung Cancer Group has promoted this review about the current situation of the existing national LC-MDTs, which also offers a set of excellence requirements and quality indicators to achieve the best care in any patient with LC. Time and sufficient resources; leadership; administrative and institutional support; and recording of activity are key factors for the success of LC-MDTs. A set of excellence requirements in terms of staff, resources and organization of the LC-MDT have been proposed. At last, a list of quality indicators has been agreed to achieve and measure the performance of current LC-MDTs.
Assuntos
Neoplasias Pulmonares/terapia , Equipe de Assistência ao Paciente , Indicadores de Qualidade em Assistência à Saúde , Humanos , EspanhaRESUMO
In 2011 the Spanish Society of Medical Oncology (SEOM) and the Spanish Society of Pathology (SEAP) started a joint project to establish guidelines on biomarker testing in patients with advanced non-small-cell lung cancer (NSCLC) based on current evidence. As this field is constantly evolving, these guidelines have been updated, previously in 2012 and 2015 and now in 2019. Current evidence suggests that the mandatory tests to conduct in all patients with advanced NSCLC are for EGFR and BRAF mutations, ALK and ROS1 rearrangements and PD-L1 expression. The growing need to study other emerging biomarkers has promoted the routine use of massive sequencing (next-generation sequencing, NGS). The coordination of every professional involved and the prioritisation of the most suitable tests and technologies for each case remains a challenge.
Assuntos
Biomarcadores Tumorais/genética , Carcinoma Pulmonar de Células não Pequenas/diagnóstico , Neoplasias Pulmonares/diagnóstico , Quinase do Linfoma Anaplásico/genética , Antígeno B7-H1/genética , Carcinoma Pulmonar de Células não Pequenas/genética , DNA Tumoral Circulante , Receptores ErbB/genética , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Imuno-Histoquímica , Hibridização in Situ Fluorescente , Biópsia Líquida , Neoplasias Pulmonares/genética , Glicoproteínas de Membrana/genética , Células Neoplásicas Circulantes , Reação em Cadeia da Polimerase , Proteínas Tirosina Quinases/genética , Proteínas Proto-Oncogênicas/genética , Proteínas Proto-Oncogênicas B-raf/genética , Proteínas Proto-Oncogênicas c-met/genética , Proteínas Proto-Oncogênicas c-ret/genética , Receptor ErbB-2/genética , Receptor trkA/genética , Receptor trkB/genética , Receptor trkC/genética , Sociedades Médicas , EspanhaRESUMO
Multidisciplinary care is needed to decide the best therapeutic approach and to provide optimal care to patients with lung cancer (LC). Multidisciplinary teams (MDTs) are optimal strategies for the management of patients with LC and have been associated with better outcomes, such as an increase in quality of life and survival. The Spanish Lung Cancer Group has promoted this review about the current situation of the existing national LC-MDTs, which also offers a set of excellence requirements and quality indicators to achieve the best care in any patient with LC. Time and sufficient resources; leadership; administrative and institutional support; and recording of activity are key factors for the success of LC-MDTs. A set of excellence requirements in terms of staff, resources and organization of the LC-MDT have been proposed. At last, a list of quality indicators has been agreed to achieve and measure the performance of current LC-MDTs.
Assuntos
Neoplasias Pulmonares/terapia , Equipe de Assistência ao Paciente , Indicadores de Qualidade em Assistência à Saúde , Assistência à Saúde Culturalmente Competente , Espanha , HistologiaRESUMO
Introducción. Los paragangliomas son tumores neuroectodérmicos poco frecuentes, de carácter neurosecretor en el 5 por ciento de los casos, que se asocian a otras tumoraciones endocrinas múltiples. Muestran tendencia a malignizar en un 10 por ciento de los casos y marcada presentación familiar. Presentamos un caso de paraganglioma localizado en el cuerpo carotídeo (quemodectoma) asociado a paraganglioma en territorio del nervio vago (con extensión hacia la base del cráneo) que requirió un abordaje laterocervical poco frecuente por medio de subluxación mandibular. Caso clínico. Paciente de 27 años de edad, sin antecedentes de interés, remitida con el diagnóstico de sospecha inicial de quiste branquial. En la exploración física por sistemas tan sólo destaca una tumoración no pulsátil en región laterocervical izquierda alta sin soplo.Las exploraciones complementarias preoperatorias incluyeron: ecografía Doppler carotídea, que mostró imagen ecogénica redondeada de 1,4 ¥ 1,86 cm en la bifurcación carotídea; TAC cervical: masa vascularizada en bulbo carotídeo izquierdo, que se extiende hacia triángulo cervical posterior compatible con tumoración glómica y vagal, y arteriografía selectiva de carótida externa izquierda, que muestra imagen de hipervascularización en bifurcación carotídea dependiente de rama posterior de la arteria carótida externa. El tratamiento quirúrgico consistió en la resección de dos tumoraciones (en bifurcación carotídea y cara posterior de la porción distal de la carótida interna izquierda, respectivamente) mediante subluxación mandibular con prótesis dentaria. El estudio inmunohistoquímico fue positivo (en ambas piezas) para cromogranina y enolasa específica en las células tumorales. Se confirmó el diagnóstico de doble paraganglioma. (AU)