Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
PLoS One. 2019 Aug 12;14(8):e0221065. doi: 10.1371/journal.pone.0221065. eCollection 2019.
Research biopsies are an essential component of cancer clinical trials for studying drug efficacy and identifying biomarkers. Site-level clinical investigators, however, do not have access to results on the adequacy of research biopsies for histological or molecular assays, because samples are sent to central labs and the test results are seldom reported back to site-level investigators unless requested. We evaluated the feasibility, safety, and adequacy of research biopsies performed at an academic medical center.
We retrospectively reviewed the data on 122 research biopsy sessions conducted in 99 patients via percutaneous core needle biopsy for 39 clinical trials from January 2017 to February 2018 at a single institute. We asked the sponsors of each clinical trial for the adequacy of the biopsy samples for histological or molecular assays.
The biopsy success rate was 93.4% (113/122), with nine samples categorized as inadequate for obtaining pathologic diagnosis. Post-biopsy complications occurred in 9.8% (12/122) of biopsies, all of which were mild and completely recovered by the day after the biopsy. The sponsors of clinical trials provided feedbacks on the adequacy of 76 biopsy samples, and noted that a total of 8 biopsy samples from 7 patients were inadequate for analysis, resulting in an adequacy rate of 89.5% (68/76): the reasons for inadequacy were insufficient tumor content for immunohistochemistry (n = 3) and low RNA yield for sequencing (n = 5).
Research biopsies performed at an experienced, multidisciplinary center had acceptable safety for patients as well as practicality in terms of obtaining adequate tissue samples for molecular studies.
研究活检是癌症临床试验的重要组成部分,用于研究药物疗效和确定生物标志物。然而,由于样本被送到中心实验室,而且除非请求,否则很少将测试结果报告回现场调查员,因此,现场级别的临床研究人员无法获得研究活检在组织学或分子检测方面是否充分的结果。我们评估了在学术医疗中心进行的研究活检的可行性、安全性和充分性。
我们回顾性地审查了 2017 年 1 月至 2018 年 2 月在一家机构进行的 99 例患者 39 项临床试验的 122 次经皮核心针活检研究活检的 122 次研究活检的数据。我们向每个临床试验的赞助商询问活检样本用于组织学或分子检测的充分性。
活检成功率为 93.4%(113/122),有 9 个样本被归类为获取病理诊断不足。活检后并发症发生率为 9.8%(12/122),所有并发症均为轻度,活检后第二天完全恢复。临床试验的赞助商对 76 个活检样本的充分性提供了反馈,并指出有 7 名患者的 8 个活检样本分析不足,总体充分率为 89.5%(68/76):分析不足的原因包括免疫组化的肿瘤含量不足(n=3)和测序的 RNA 产量低(n=5)。
在经验丰富的多学科中心进行的研究活检对患者具有可接受的安全性,并且在获得足够的组织样本进行分子研究方面具有实用性。