Xu Mingxuan, Tapia Coya, Hajjar Joud, Sabir Sharjeel, Colen Rivka, Nagarajan Priyadharsini, Aung Phyu P, Gong Jing, Rodon Jordi, Fu Siqing, Stephen Bettzy, Roy-Chowdhuri Sinchita, Le Hung, Yang Vincent, Zarifa Abdulrazzak, Abdelsalam Mohamed Elsayed, Jhingran Anuja, Javle Milind, Pant Shubham, Carter Brett, Milton Denai R, Sun Ryan, Karp Daniel D, Koay Eugene Jon, Yang Yali, Wistuba Ignacio I, Hwu Patrick, Meric-Bernstam Funda, Naing Aung
Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
J Immunother Precis Oncol. 2021 May 14;4(2):45-52. doi: 10.36401/JIPO-21-5. eCollection 2021 May.
For maximum utility of molecular characterization by next-generation sequencing (NGS) and better understanding of tumor microenvironment with immune correlates analysis, biopsy specimens must yield adequate tumor tissue, and sequential biopsy specimens should sample a consistent site. We developed a web-based lesion selection tool (LST) that enables management and tracking of the biopsy specimen collections.
Of 145 patients, the LST was used for 88 patients; the other 57 served as controls. We evaluated consistency of the lesion biopsied in longitudinal collections, number of cores obtained, and cores with adequate tumor cellularity for NGS. The Fisher exact test and Wilcoxon rank sum test were used to identify differences between the groups.
The analysis included 30 of 88 (34%) patients in the LST group and 52 of 57 (91%) in the control group. The LST workflow ensured 100% consistency in the lesions biopsied compared with 75% in the control group in longitudinal collections and increased the proportion of patients in whom at least five cores were collected per biopsy.
The novel LST platform facilitates coordination, performance, and management of longitudinal biopsy specimens. Use of the LST enables sampling of the designated lesion consistently, which is likely to accurately inform us the effect of the treatment on tumor microenvironment and evolution of resistant pathways. Such studies are important translational component of any clinical trials and research as they guide the development of next line of therapy, which has significant effect on clinical utility. However, validation of this approach in a larger study is warranted.
为了通过下一代测序（NGS）实现分子特征的最大效用，并通过免疫相关分析更好地了解肿瘤微环境，活检标本必须产生足够的肿瘤组织，并且连续活检标本应取自一致的部位。我们开发了一种基于网络的病变选择工具（LST），可实现活检标本采集的管理和跟踪。
在145例患者中，88例患者使用了LST；另外57例作为对照。我们评估了纵向采集的活检病变的一致性、获取的芯块数量以及用于NGS的具有足够肿瘤细胞密度的芯块。采用Fisher精确检验和Wilcoxon秩和检验来确定两组之间的差异。
分析包括LST组88例患者中的30例（34%）和对照组57例患者中的52例（91%）。LST工作流程确保纵向采集中活检病变的一致性为100%，而对照组为75%，并增加了每次活检至少采集5个芯块的患者比例。
新型LST平台有助于纵向活检标本的协调、实施和管理。使用LST能够始终如一地对指定病变进行采样，这可能会准确地告知我们治疗对肿瘤微环境的影响以及耐药途径的演变。此类研究作为任何临床试验和研究的重要转化组成部分，因为它们指导下一线治疗的开发，对临床效用有重大影响。然而，需要在更大规模的研究中验证这种方法。
