Targeted Oncology

, Volume 10, Issue 2, pp 247–253 | Cite as

Rebiopsy during disease progression in patients treated by TKI for oncogene-addicted NSCLC

  • Cecile Bosc
  • Gilbert R. Ferretti
  • Jacques Cadranel
  • Clarisse Audigier-Valette
  • Benjamin Besse
  • Fabrice Barlesi
  • Chantal Decroisette
  • Sylvie Lantuejoul
  • François Arbib
  • Denis Moro-Sibilot
Original Research

Abstract

All lung cancer patients with mutant epidermal growth factor receptor (EGFR) or rearranged EML4-ALK eventually develop acquired resistance to treatment. Rebiopsy may give insight into the resistance mechanisms and direct further lines of treatment. Here, we evaluate the potential interest and limitations of rebiopsy. Patients with mutant EGFR or rearranged EML4-ALK non-small cell lung cancer (NSCLC) and acquired resistance to tyrosine kinase inhibitors were included in a retrospective study to determine the percentage of patients who underwent rebiopsy and whether rebiopsy would have been possible, or not, in the remaining patients. In a cohort of 84 patients from 6 institutions, a biopsy had been performed in 39 cases. Biopsy samples were sufficient for histopathological or cytological examination in 35 cases (89.7 %). Complete or partial response had been observed in 84.5 % of patients whose cancer further progressed and who underwent rebiopsy. A biopsy could have been considered in 30 of the 45 remaining patients. Those with brain (N = 9) and bone (N = 2) metastases and/or with contraindications (N = 6) were excluded (two patients had both brain metastases and a contraindication). The rebiopsy target was thoracic in 62 % of cases and on distant metastases in 38 % of cases. Patients with NSCLC and an activating mutation could undergo a rebiopsy in 72 % of cases. A response to treatment does not preclude the possibility of rebiopsy at the time of progression.

Keywords

EGFR mutant lung cancer ALK rearrangement Targeted therapy Acquired resistance Molecular diagnosis 

Notes

Acknowledgments

We thank Dr Alison Foote (Grenoble Clinical Research Centre) for critically reading and editing the manuscript with particular attention to English usage.

Conflict of interest

Denis Moro-Sibilot has consulted for Pfizer, Boehringer Ingelheim, Roche, AstraZeneca, Eli Lilly, AMGEN, Sanofi Aventis, and Novartis.

Gilbert Ferretti reports personal fees from Boehringer Ingelheim, non-financial support from Guerbet, personal fees from Intermune, personal fees from Roche, personal fees from Pfizer, personal fees from Lilly, and personal fees from Actelion, outside the submitted work.

The other authors declare that they have no conflict of interest.

Supplementary material

11523_2014_332_MOESM1_ESM.docx (14 kb)
Table A(DOCX 13 kb)

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Copyright information

© Springer International Publishing Switzerland 2014

Authors and Affiliations

  • Cecile Bosc
    • 1
  • Gilbert R. Ferretti
    • 2
  • Jacques Cadranel
    • 3
  • Clarisse Audigier-Valette
    • 4
  • Benjamin Besse
    • 5
  • Fabrice Barlesi
    • 6
  • Chantal Decroisette
    • 7
  • Sylvie Lantuejoul
    • 8
  • François Arbib
    • 1
  • Denis Moro-Sibilot
    • 1
    • 9
  1. 1.Unité d’Oncologie Thoracique, PCMAC, CHU Grenoble France and INSERM U 823GrenobleFrance
  2. 2.Clinique Universitaire de Radiologie et Imagerie Médicale, Université Alpes-GrenobleCHU GrenobleGrenobleFrance
  3. 3.Service de Pneumologie Hôpital Tenon et, GRC-04 TheranoscanUniversité Pierre-et-Marie CurieParisFrance
  4. 4.Service de Pneumologie Hôpital Sainte MusseToulonFrance
  5. 5.Departement de MédecineInstitut Gustave RoussyVillejuifFrance
  6. 6.Unité Oncologie Multidisciplinaire et Innovations ThérapeutiquesUniversité Aix Marseille–Assistance Publique Hôpitaux de MarseilleMarseilleFrance
  7. 7.Service de Pneumologie Hôpital d’AnnecyAnnecyFrance
  8. 8.Service d’AnatomopathologieCHU GrenobleGrenobleFrance
  9. 9.Thoracic Oncology UnitCHU de GrenobleGrenoble Cedex 9France

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