Abstract
Objectives: Re-biopsy is recommended in patients with lung cancer progression, particularly in case of oncogene-driven tumours in order to identify mechanisms of acquired resistance. The impact of re-biopsy in patients with non-oncogene-driven lung cancer is still unclear. This analysis evaluates the safety and impact of bronchoscopic re-biopsy in patients with progressive lung cancer.
Methods: From 01/2017-06/2017, 85 patients with lung cancer underwent bronchoscopic re-biopsy for disease progression. Radiological, bronchoscopic and pathological reports were retrospectively evaluated.
Results: 85 patients (mean age 64 years, 54% male) with progressive adenocarcinoma (n=41), squamous cell carcinoma (n=15), small-cell lung carcinoma (n=24) and NSCLC, NOS (n=5) underwent bronchoscopic re-biopsy. Mutations and PDL1 expression were initially examined in 47% (40/85) and 37% (31/85) respectively, showing mutations in 16 and PDL1 positivity (>50%) in 8 patients. Previous therapies included surgery (n=5), radiotherapy (n=36), chemotherapy (n=73), targeted treatment (n=10) and immunotherapy (n=6). Procedures performed were endobronchial biopsy (n=60), EBUS-TBNA (n=11) and transbronchial biopsy (n=22). Overall detection rate for malignancy was 69% (59/85). Histologic change was found in 7% (4/59). Mutations and PDL1-expression were examined in 22% (13/59) and in 31% (18/59), demonstrating new mutations in 6 and PDL1-positivity in 2 patients. No severe complications were reported.
Conclusion: Bronchoscopic re-biopsy for progressive lung cancer is feasible and safe. Histological change can be detected in a considerable number of patients, which is potentially valuable information for guidance of subsequent treatment.
Footnotes
Cite this article as: European Respiratory Journal 2019; 54: Suppl. 63, PA3062.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2019