P1.03-004 Percutaneous Lung Biopsy for Genomic Assessment: Comparison between Two Different next Generation Sequencing Platforms

Abstract

Purpose: Compare the successful use of percutaneous lung biopsy for two different next generation sequencing (NGS) platforms. Retrospective review of 232 consecutive lung cancer patients who underwent a histologically diagnostic image guided lung biopsy for NGS between 4/2013 and 12/2014 with samples sent for NGS. Procedures were performed using 19 gauge coaxial guide needles, 20 gauge side-cutting core needles and 22 gauge Chiba FNA needles. If a request for analysis of 2 or more gene mutations was received, samples were evaluated for NGS. A minimum sample tumor cellularity of 20% on pathology review was required to send for NGS. Next DNA was extracted from the samples and amount of DNA was assessed. Sequencing was performed with a 46-gene or 50-gene multiplex platform (Iron Torrent Personal Genome Machine). Patient demographics, lesion imaging, procedural technique and NGS success were collected. Descriptive statistics were tabulated. Two tailed Fisher’s exact test was calculated to compare success rate of the two NGS platforms. The average age of the patients was 66 years (34 – 91). 59.05% were female, 65.52% had history of smoking, 89.22% of the tumors biopsied were primary lung cancer and 10.78% were lung metastasis from lung cancer. Average lesion size was 4.07 cm (0.8 – 15.6). 84.91% of the lesions were spiculated, 78% were solid and 4.74% had calcification. 20.69% of the patients had pleural effusion, 65.08% had known metastasis and 20.25% had systemic treatment within three months prior to the procedure. Average lesion distance from the pleura was 1.87 cm (0 to 8.5 cm). 48.70% of the biopsies had local hemorrhage during the procedure, 18.10% developed pneumothorax and 5.17% needed a chest tube. 44 biopsies were collected for NGS with 46-gene multiplex platform (CMS-46) and 188 for 50-gene (CMS-50) assessment. The success rate was 59.09% for CMS-46 and 80.85% for CMS-50 (p=0.0048). There is a significant difference in the successful use of percutaneous lung biopsy with two different NGS platforms.