OBJECTIVES: Targeted therapies for non-small-cell lung cancers (NSCLCs) are based on the presence of driver mutations such as epidermal growth factor receptor (EGFR) and the echinoderm microtubule-associated protein-like 4-anaplastic lymphoma kinase (EML4-ALK) translocation. Endobronchial ultrasound-guided-transbronchial needle aspiration (EBUS-TBNA) is a first-line modality for diagnosing and staging NSCLC. A quality improvement protocol maximizing tissue acquisition for molecular analysis has not been previously described. METHODS: We instituted a standardized protocol designed from a multidisciplinary meeting of the pulmonology, oncology, and pathology departments for the acquisition and on-site processing of samples obtained through EBUS-TBNA to improve the yield for genetic analysis of EGFR and ALK testing. RESULTS: Preprotocol there were 50 NSCLCs (29 adenocarcinomas) and postprotocol there were 109 NSCLCs (52 adenocarcinomas). A statistically significant increase in yield for molecular analysis was seen in both EGFR (36% preprotocol and 80% postprotocol, P < 0.01) and ALK (41% preprotocol and 80% postprotocol, P < 0.01). There was no difference in complications preprotocol and postprotocol. CONCLUSIONS: Implementation of a standardized protocol with EBUS-TBNA was associated with an increase in adequacy for molecular genetic analysis in NSCLC.
OBJECTIVES: Targeted therapies for non-small-cell lung cancers (NSCLCs) are based on the presence of driver mutations such as epidermal growth factor receptor (EGFR) and the echinoderm microtubule-associated protein-like 4-anaplastic lymphoma kinase (EML4-ALK) translocation. Endobronchial ultrasound-guided-transbronchial needle aspiration (EBUS-TBNA) is a first-line modality for diagnosing and staging NSCLC. A quality improvement protocol maximizing tissue acquisition for molecular analysis has not been previously described. METHODS: We instituted a standardized protocol designed from a multidisciplinary meeting of the pulmonology, oncology, and pathology departments for the acquisition and on-site processing of samples obtained through EBUS-TBNA to improve the yield for genetic analysis of EGFR and ALK testing. RESULTS:Preprotocol there were 50 NSCLCs (29 adenocarcinomas) and postprotocol there were 109 NSCLCs (52 adenocarcinomas). A statistically significant increase in yield for molecular analysis was seen in both EGFR (36% preprotocol and 80% postprotocol, P < 0.01) and ALK (41% preprotocol and 80% postprotocol, P < 0.01). There was no difference in complications preprotocol and postprotocol. CONCLUSIONS: Implementation of a standardized protocol with EBUS-TBNA was associated with an increase in adequacy for molecular genetic analysis in NSCLC.
Authors: David E Ost; Armin Ernst; Xiudong Lei; David Feller-Kopman; George A Eapen; Kevin L Kovitz; Felix J F Herth; Michael Simoff Journal: Chest Date: 2011-06-09 Impact factor: 9.410
Authors: Christina R Bellinger; Arjun B Chatterjee; Norman Adair; Tim Houle; Irtaza Khan; Edward Haponik Journal: Respiration Date: 2014-11-12 Impact factor: 3.580
Authors: Emily Hopkins; David Moffat; Ian Parkinson; Peter Robinson; Hubertus Jersmann; Brendan Dougherty; Mohammed I Birader; Kate Francis; Phan Nguyen Journal: J Thorac Dis Date: 2016-09 Impact factor: 2.895
Authors: Lonny Yarmus; Jason Akulian; Christopher Gilbert; David Feller-Kopman; Hans J Lee; Paul Zarogoulidis; Noah Lechtzin; Syed Z Ali; Vidya Sathiyamoorthy Journal: Ann Am Thorac Soc Date: 2013-12
Authors: Christina R Bellinger; Arjun B Chatterjee; Robert Chin; John Conforti; Norman Adair; Edward Haponik Journal: South Med J Date: 2012-12 Impact factor: 0.954
Authors: Gerard A Silvestri; Anne V Gonzalez; Michael A Jantz; Mitchell L Margolis; Michael K Gould; Lynn T Tanoue; Loren J Harris; Frank C Detterbeck Journal: Chest Date: 2013-05 Impact factor: 9.410