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ASPYRE-Lung靶向变异检测板的评估:一种用于非小细胞肺癌生物标志物检测的快速、低投入解决方案及来自三个独立站点的经验

Evaluation of the ASPYRE-Lung targeted variant panel: a rapid, low-input solution for non-small cell lung cancer biomarker testing and experience from three independent sites.

作者信息

Herlihy Sarah E, Gentile Caren, Scott Samantha J, Smith Brandon A, Stoll Kathryn A, Schilter Kala F, Mordaka Justyna M, Palmer Rebecca N, Xyrafaki Christina, Gillon-Zhang Elizabeth, King Candace, Evans Ryan T, Green Amanda S, Silva Ana-Luisa, Stolarek-Januszkiewicz Magdalena, von Bargen Kristine, Turner Iyelola, Ho Chau Ha, Collazos Alejandra, Potts Nicola D, Nugent Dilyara, Jose Jinsy, Gray Eleanor R, Shapiro Elyse, Levin Wendy J, Cooke Aishling, Balmforth Barnaby W, Osborne Robert J, Reddi Honey V, Van Deerlin Vivianna M

机构信息

Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.

Precision Medicine Laboratory, Division of Clinical Genomics, Medical College of Wisconsin, Milwaukee, WI, USA.

出版信息

Transl Lung Cancer Res. 2024 Nov 30;13(11):3083-3095. doi: 10.21037/tlcr-24-525. Epub 2024 Nov 28.

Abstract

BACKGROUND

Many patients with non-small cell lung cancer (NSCLC) lack access to highly effective approved targeted therapeutics due to multiple gaps in biomarker testing. Challenges in comprehensive molecular testing include complexities associated with the need to assess the presence of multiple variants, costs of running multiple sequential assays per sample, high assay quality control (QC) failure rates, clinical need for rapid turn-around time (TAT) to initiate therapy, and insufficient tissue samples. The ASPYRE-Lung NSCLC assay addresses gaps in multiplexed testing by simultaneously analyzing DNA and RNA, detecting 114 actionable genomic variants across 11 genes, consistent with current NSCLC treatment guidelines. This study was to assess the ease of adoption and performance of ASPYRE-Lung in third-party laboratories, comparing concordance across sites and with orthogonal methods.

METHODS

ASPYRE-Lung was established at two academic centers with multiple operators per site. Assay concordance was evaluated across three sites using 77 patient samples [61 derived from formalin-fixed paraffin-embedded (FFPE) tissue and 16 from cytology specimens].

RESULTS

Reproducibility for all 77 samples yielded a positive percent agreement (PPA) of 100% and negative percent agreement (NPA) of 99.99%. Concordance with next-generation sequencing (NGS)-based methods across all three sites was high with PPA of 97.2% and NPA of 99.96%.

CONCLUSIONS

ASPYRE-Lung assay is a cost-effective, easy to adopt testing method requiring no specialized expertise or complicated bioinformatics, with the potential to inform genomic data on small tissue samples, thus enabling all patients with NSCLC to undergo biomarker testing in a timely manner and benefit from appropriate targeted therapies.

摘要

背景

由于生物标志物检测存在多个差距,许多非小细胞肺癌(NSCLC)患者无法获得经批准的高效靶向治疗药物。全面分子检测面临的挑战包括与评估多种变异体存在相关的复杂性、每个样本进行多个连续检测的成本、高检测质量控制(QC)失败率、临床对快速周转时间(TAT)以启动治疗的需求以及组织样本不足。ASPYRE-Lung NSCLC检测通过同时分析DNA和RNA,检测11个基因中的114个可操作基因组变异体,解决了多重检测中的差距,符合当前NSCLC治疗指南。本研究旨在评估ASPYRE-Lung在第三方实验室中的采用便利性和性能,比较不同位点之间以及与正交方法的一致性。

方法

在两个学术中心建立了ASPYRE-Lung检测,每个位点有多个操作人员。使用77份患者样本[61份来自福尔马林固定石蜡包埋(FFPE)组织,16份来自细胞学标本]在三个位点评估检测一致性。

结果

所有77个样本的重复性产生的阳性百分一致性(PPA)为100%,阴性百分一致性(NPA)为99.99%。在所有三个位点与基于下一代测序(NGS)的方法的一致性很高,PPA为97.2%,NPA为99.96%。

结论

ASPYRE-Lung检测是一种经济高效、易于采用的检测方法,不需要专门的专业知识或复杂的生物信息学,有可能为小组织样本提供基因组数据,从而使所有NSCLC患者能够及时进行生物标志物检测并受益于适当的靶向治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5b1/11632423/2e664f2e3b8b/tlcr-13-11-3083-f1.jpg

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