Prospective detection of mutations in cerebrospinal fluid, pleural effusion, and ascites of advanced cancer patients to guide treatment decisions
Por:
Villatoro, S, Mayo-de-las-Casas, C, Jordana-Ariza, N, Viteri-Ramirez, S, Garzon-Ibanez, M, Moya-Horno, I, Garcia-Pelaez, B, Gonzalez-Cao, M, Malapelle, U, Balada-Bel, A, Martinez-Bueno, A, Campos, R, Reguart, N, Majem, M, Blanco, R, Blasco, A, Catalan, MJ, Gonzalez, X, Troncone, G, Karachaliou, N, Rosell, R and Molina-Vila, MA
Publicada:
1 dic 2019
Ahead of Print:
1 oct 2019
Resumen:
Many advanced cases of cancer show central nervous system, pleural, or peritoneal involvement. In this study, we prospectively analyzed if cerebrospinal fluid (CSF), pleural effusion (PE), and/or ascites (ASC) can be used to detect driver mutations and guide treatment decisions. We collected 42 CSF, PE, and ASC samples from advanced non-small-cell lung cancer and melanoma patients. Cell-free DNA (cfDNA) was purified and driver mutations analyzed and quantified by PNA-Q-PCR or next-generation sequencing. All 42 fluid samples were evaluable; clinically relevant mutations were detected in 41 (97.6%). Twenty-three fluids had paired blood samples, 22 were mutation positive in fluid but only 14 in blood, and the abundance of the mutant alleles was significantly higher in fluids. Of the 34 fluids obtained at progression to different therapies, EGFR resistance mutations were detected in nine and ALK acquired mutations in two. The results of testing of CSF, PE, and ASC were used to guide treatment decisions, such as initiation of osimertinib treatment or selection of specific ALK tyrosine-kinase inhibitors. In conclusion, fluids close to metastatic sites are superior to blood for the detection of relevant mutations and can offer valuable clinical information, particularly in patients progressing to targeted therapies.
Filiaciones:
Villatoro, S:
Quiron Dexeus Univ Hosp, Lab Oncol, Pangaea Oncol, Extemal Consultat Bldg,Room 1-7, Barcelona 08028, Spain
Mayo-de-las-Casas, C:
Quiron Dexeus Univ Hosp, Lab Oncol, Pangaea Oncol, Extemal Consultat Bldg,Room 1-7, Barcelona 08028, Spain
Jordana-Ariza, N:
Quiron Dexeus Univ Hosp, Lab Oncol, Pangaea Oncol, Extemal Consultat Bldg,Room 1-7, Barcelona 08028, Spain
Viteri-Ramirez, S:
Quiron Dexeus Univ Hosp, Dr Rosell Oncol Inst, Barcelona, Spain
Garzon-Ibanez, M:
Quiron Dexeus Univ Hosp, Lab Oncol, Pangaea Oncol, Extemal Consultat Bldg,Room 1-7, Barcelona 08028, Spain
Moya-Horno, I:
Gen Hosp Catalonia, Dr Rosell Oncol Inst, Sant Cugat Del Valles, Spain
Garcia-Pelaez, B:
Quiron Dexeus Univ Hosp, Lab Oncol, Pangaea Oncol, Extemal Consultat Bldg,Room 1-7, Barcelona 08028, Spain
Gonzalez-Cao, M:
Quiron Dexeus Univ Hosp, Dr Rosell Oncol Inst, Barcelona, Spain
Malapelle, U:
Univ Naples Federico II, Dept Publ Hlth, Naples, Italy
Balada-Bel, A:
Quiron Dexeus Univ Hosp, Lab Oncol, Pangaea Oncol, Extemal Consultat Bldg,Room 1-7, Barcelona 08028, Spain
Martinez-Bueno, A:
Quiron Dexeus Univ Hosp, Dr Rosell Oncol Inst, Barcelona, Spain
Campos, R:
Quiron Dexeus Univ Hosp, Lab Oncol, Pangaea Oncol, Extemal Consultat Bldg,Room 1-7, Barcelona 08028, Spain
Reguart, N:
Hosp Clin Barcelona, Dept Med Oncol, Barcelona, Spain
Majem, M:
Hosp Santa Creu & Sant Pau, Med Oncol Serv, Barcelona, Spain
Blanco, R:
Hosp Terrassa, Med Oncol Serv, Barcelona, Spain
Blasco, A:
Hosp Gen Univ Valencia, Med Oncol Dept, Valencia, Spain
Catalan, MJ:
Quiron Dexeus Univ Hosp, Lab Oncol, Pangaea Oncol, Extemal Consultat Bldg,Room 1-7, Barcelona 08028, Spain
Gonzalez, X:
Gen Hosp Catalonia, Dr Rosell Oncol Inst, Sant Cugat Del Valles, Spain
Troncone, G:
Univ Naples Federico II, Dept Publ Hlth, Naples, Italy
Karachaliou, N:
Quiron Dexeus Univ Hosp, Lab Oncol, Pangaea Oncol, Extemal Consultat Bldg,Room 1-7, Barcelona 08028, Spain
Univ Hosp Sagrat Cor, Dr Rosen Oncol Inst, Barcelona, Spain
:
Quiron Dexeus Univ Hosp, Lab Oncol, Pangaea Oncol, Extemal Consultat Bldg,Room 1-7, Barcelona 08028, Spain
Quiron Dexeus Univ Hosp, Dr Rosell Oncol Inst, Barcelona, Spain
Germans Trias & Pujol Hlth Sci Inst & Hosp, Catalan Inst Oncol, Canc Biol & Precis Med Program, Badelona, Spain
Molina-Vila, MA:
Quiron Dexeus Univ Hosp, Lab Oncol, Pangaea Oncol, Extemal Consultat Bldg,Room 1-7, Barcelona 08028, Spain
gold, Green Published
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