Skip to main content

Advertisement

SpringerLink
Log in

The Clinical Impact of Re-biopsies in Lung Adenocarcinoma: a Retrospective Multicenter Study

  • Original Article
  • Published:
Pathology & Oncology Research

Abstract

If a patient’s cancer progresses while undergoing targeted therapy, a re-biopsy is not mandatory. But when evaluating the benefits and risks on a case-by-case basis (transformation to small cell, assessing for a clinical trial), physicians should inform patients about the possible need for a re-biopsy (5). This was a retrospective and multicentre study. A total of 644 patients with lung adenocarcinoma were reviewed, 625 of whom were ruled eligible. From them, 399 were found to show disease progression, and 126 re-biopsies were performed. Progression status, re-biopsy sites, success of obtaining adequate tissue, molecular patterns after re-biopsy and subsequent treatments were analysed. Survival differences among patients with disease progression were then examined according to re-biopsy status. Overall, 625 patients with adenocarcinoma and a median age of 61.4 were evaluated. Initial tyrosine kinase inhibitor (TKI) usage numbered 37 patients (5.9%). Progression was diagnosed in 399 (63.8%) patients, out of which 26 (31.6%) underwent re-biopsies. The successful number of re-biopsies was 103 (81.7%). No complications were observed after any of the biopsy procedures. Subsequent treatments were changed in 15 patients (11.9%), who began new TKI treatments. Poor performance status was the most common reason for not performing a biopsy (n = 65; 23.8%), followed by the physician’s decision (n = 40; 14.6%). Re-biopsies can demonstrate the new characteristics of a tumour and can detect the activation of pre-existing clones, making possible new treatment opportunities for patients. According to the performance status of the patient and the availability of the progressive lesion, we should increase the rate of re-biopsies before the decision to follow up with the best supportive care.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Ettinger DS, Aisner DL, Wood DE, Akerley W, Bauman J, Chang JY et al (2018 Jul) NCCN Guidelines Insights: Non-Small Cell Lung Cancer, Version 5.2018. J Natl Compr Canc Netw 16(7):807–821

  2. Lindeman NI, Cagle PT, Aisner DL, Arcila ME, Beasley MB, Bernicker EH et al (2018 Mar) Updated Molecular Testing Guideline for the Selection of Lung Cancer Patients for Treatment With Targeted Tyrosine Kinase Inhibitors: Guideline From the College of American Pathologists, the International Association for the Study of Lung Cancer, and the Association for Molecular Pathology. Arch Pathol Lab Med 142(3):321–346

  3. Huang D, Kim DW, Kotsakis A, Deng S, Lira P, Ho SN et al (2013) Multiplexed deep sequencing analysis of ALK kinase domain identifies resistance mutations in relapsed patients following crizotinib treatment. Genomics 102(3):157–162

    Article  CAS  Google Scholar 

  4. Vavalà T, Novello S (2018 Aug) Alectinib in the treatment of ALK-positive non-small cell lung cancer: an update on its properties, efficacy, safety and place in therapy. Ther Adv Med Oncol 3:10:1758835918789364

  5. Besse B, Adjei A, Baas P, Meldgaard P, Nicolson M, Paz-Ares L et al (2014) 2nd ESMO Consensus Conference on Lung Cancer: non-small-cell lung cancer first-line/second and further lines of treatment in advanced disease. Ann Oncol 25(8):1475-84

  6. Therasse P, Arbuck SG, Eisenhauer EA, Wanders J, Kaplan RS, Rubinstein L et al (2000) New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst 92:205–216

    Article  CAS  Google Scholar 

  7. Thunnissen E (2012 Dec) Pulmonary adenocarcinoma histology. Transl Lung Cancer Res 1(4):276–279

  8. Rossi G, Pelosi G, Graziano P, Barbareschi M, Papotti M (2009) A reevaluation of the clinical significance of histological subtyping of non–small-cell lung carcinoma: Diagnostic algorithms in the era of personalized treatments. Int J Surg Pathol 17(3):206–18

    Article  Google Scholar 

  9. Kawamura T, Kenmotsu H, Taira T, Omori S, Nakashima K, Wakuda K et al (2016 Jul) Rebiopsy for patients with non-small-cell lung cancer after epidermal growth factor receptor-tyrosine kinase inhibitor failure. Cancer Sci 107(7):1001–1005

  10. Nosaki K, Inamasu E, Shimamatsu S, Yoshida T, Toyokawa G, Hirai F et al. Re-biopsy in advanced non-small cell lung cancer patients after the development of 3rd generation EGFR-TKI and new targeted therapies. https://doi.org/10.1200/jco.2015.33.15_suppl.e19081

  11. Yoon HJ, Lee HY, Lee KS, Choi YL, Ahn MJ, Park K et al (2012 Dec) Repeat biopsy for mutational analysis of non-small cell lung cancers resistant to previous chemotherapy: adequacy and complications. Radiology 265(3):939–948

  12. Thunnissen E, Kerr KM, Herth FJV, Lantuejoul S, Papotti M, Rintoul RC et al (2012) The challenge of NSCLC diagnosis and predictive analysis on small samples. Practical approach of a working group. Lung Cancer 76:1–18

    Article  Google Scholar 

  13. Yatabe Y (2010) EGFR mutations and the terminal respiratory unit. Cancer Metastasis Rev 29:23–36

    Article  CAS  Google Scholar 

  14. Jekunen AP (2015) Role of rebiopsy in relapsed non-small cell lung cancer for directing oncology treatments. J Oncol 2015:809835

    Article  Google Scholar 

  15. Hata A, Katakami N, Nanjo S, Okuda C, Kaji R, Imai Y. Rebiopsy of Histological Samples in Pretreated Non-small Cell Lung Cancer: Comparison Among Rebiopsy Procedures. In Vivo. 2017 31(3):475–479

Download references

Acknowledgements

Conception and design: Ülkü Yılmaz, MuzafferMetintaş, Güntülü Ak, Funda Demirağ

Data collection: Derya Kızılgöz, SunaKavurgacı, Şenay Yılmaz, Nilgün Yılmaz Demirci

Analysis: Selma Metintaş, Pınar Akın Kabalak,Nilgün Yılmaz Demirci

Writing: Pınar Akın Kabalak, Güntülü Ak, Şenay Yılmaz

Guarantor: Ülkü Yılmaz

Pathology: Funda Demirağ

Author information

Authors and Affiliations

  1. Department of Chest Disease, Atatürk Chest Disease and Thoracic Surgery Teaching and Research Hospital, 06290, Ankara, Turkey

    Pınar Akın Kabalak, Derya Kızılgöz, Suna Kavurgacı & Ülkü Yılmaz

  2. Department of Chest Disease, Gazi University School of Medicine, Ankara, Turkey

    Nilgün Yılmaz Demirci

  3. Lung and Pleural Cancers Research and Clinical Center, Eskisehir Osmangazi University, Eskisehir, Turkey

    Şenay Yılmaz, Güntülü Ak, Selma Metintaş & Muzaffer Metintaş

  4. School of Medicine, Department of Public Health, Eskisehir Osmangazi University, Eskisehir, Turkey

    Selma Metintaş

  5. Department of Pathology, Atatürk Chest Disease and Thoracic Surgery Teaching and Research Hospital, Ankara, Turkey

    Funda Demirağ

Authors
  1. Pınar Akın Kabalak
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Derya Kızılgöz
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Suna Kavurgacı
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Nilgün Yılmaz Demirci
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Şenay Yılmaz
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Güntülü Ak
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Selma Metintaş
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Muzaffer Metintaş
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Funda Demirağ
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Ülkü Yılmaz
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Pınar Akın Kabalak.

Ethics declarations

Conflicts of Interest

The authors they have no conflicts of interest or received financial support for this study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kabalak, P.A., Kızılgöz, D., Kavurgacı, S. et al. The Clinical Impact of Re-biopsies in Lung Adenocarcinoma: a Retrospective Multicenter Study. Pathol. Oncol. Res. 26, 2703–2708 (2020). https://doi.org/10.1007/s12253-020-00876-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12253-020-00876-2

Keywords

Search

Navigation