Targeted Assessment of the Status as Reflex Testing in Treatment-Naive Non-Squamous Cell Lung Carcinoma Patients: A Single Laboratory Experience (LPCE, Nice, France).

BACKGROUND

Assessment of actionable mutations is mandatory for treatment-naïve advanced or metastatic non-squamous lung carcinoma (NSLC), but the results need to be obtained in less than 10 working days. For rapid testing, an -specific polymerase chain reaction (PCR) assay is an alternative and simple approach compared to next generation sequencing (NGS). Here, we describe how a rapid -specific PCR assay can be implemented in a single laboratory center (LPCE, Nice, France) as reflex testing in treatment-naïve NSLC.

METHODS

A total of 901 biopsies from NSLC with more than 10% of tumor cells were prospectively and consecutively evaluated for mutation status between November 2017 and December 2019 using the Idylla system (Biocartis NV, Mechelen, Belgium). NGS was performed for nonsmokers with NSLC wild type for , , , and and with less than 50% PD-L1 positive cells using the Hotspot panel (Thermo Fisher Scientific, Waltham, MA, USA).

RESULTS

Results were obtained from 889/901 (97%) biopsies with detection of mutations in 114/889 (13%) cases using the Idylla system. Among the 562 wild type tumors identified with Idylla, NGS detected one actionable and one nonactionable mutation.

CONCLUSIONS

Rapid and targeted assessment of mutations in treatment-naïve NSLC can be implemented in routine clinical practice. However, it is mandatory to integrate this approach into a molecular algorithm that allows evaluation of potentially actionable genomic alterations other than mutations.