0
Original Research: Lung Cancer |

Randomized Trial of Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration With and Without Rapid On-site Evaluation for Lung Cancer GenotypingRapid On-site Evaluation for Cancer Genotyping

Rocco Trisolini, MD, FCCP; Alessandra Cancellieri, MD; Carmine Tinelli, MD; Dario de Biase, PhD; Ilaria Valentini, MD; Gianpiero Casadei, MD; Daniela Paioli, MD; Franco Ferrari, MD; Giovanni Gordini, MD; Marco Patelli, MD, FCCP; Giovanni Tallini, MD, PhD
Author and Funding Information

From the Interventional Pulmonology Unit (Dr Trisolini), Policlinico Sant’Orsola-Malpighi, Bologna; the Thoracic Endoscopy and Pulmonology Unit (Drs Trisolini, Valentini, Paioli, and Patelli), the Pathology Unit (Drs Cancellieri and Casadei), and the Intensive Care Unit/118 EMS (Drs Ferrari and Gordini), Maggiore Hospital, Bologna; the Pathology Unit (Drs de Biase and Tallini), Bellaria Hospital, Bologna; and the Clinical Epidemiology and Biometry Service (Dr Tinelli), IRCCS Policlinico San Matteo, Pavia, Italy.

CORRESPONDENCE TO: Rocco Trisolini, MD, FCCP, Interventional Pulmonology Unit, Policlinico S. Orsola-Malpighi, via Albertoni 15, 40138 Bologna, Italy; e-mail: rocco.trisolini@aosp.bo.it


FUNDING/SUPPORT: The authors have reported to CHEST that no funding was received for this study.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2015;148(6):1430-1437. doi:10.1378/chest.15-0583
Text Size: A A A
Published online

BACKGROUND:  Experts and scientific society guidelines recommend that rapid on-site evaluation (ROSE) be used with endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) to optimize lung cancer genotyping, but no comparative trial has been carried out to confirm and quantify its usefulness.

METHODS:  To assess the influence of ROSE on the yield of EBUS-TBNA for a multigene molecular analysis of lung cancer samples, consecutive patients with suspected or known advanced lung cancer were randomized to undergo EBUS-TBNA without ROSE (EBUS arm) or with ROSE (ROSE arm). The primary end point was the rate of the successful accomplishment of the institution’s clinical protocol for molecular profiling of nonsquamous non-small cell lung cancer (EGFR and KRAS testing, followed by ALK testing for tumors with EGFR and KRAS wild-type status).

RESULTS:  Complete genotyping was achieved in 108 of 126 patients (85.7%) (90.8% in the ROSE arm vs 80.3% in the EBUS arm, P = .09). The patients in the ROSE arm were less likely to have samples that could be used only for pathologic diagnosis because of minimal tumor burden (0 vs 6, P = .05), and were more likely to have the bronchoscopy terminated after a single biopsy site (58.9% vs 44.1%, P = .01).

CONCLUSIONS:  ROSE prevents the need for a repeat invasive diagnostic procedure aimed at molecular profiling in at least one out of 10 patients with advanced lung cancer and significantly reduces the risk of retrieving samples that can be used only for pathologic subtyping because of minimal tumor burden.

TRIAL REGISTRY:  ClinicalTrials.gov; No.: NCT01799382; URL: www.clinicaltrials.gov

Figures in this Article

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
Guidelines
Nausea and vomiting.
Association of Comprehensive Cancer Centres | 10/17/2008
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543