{
  "abstract": "Background Next-Generation Sequencing (NGS) allows the use of more efficacious targeted treatments for lung cancer; however, sample inadequacy can cause delays in patient pathways. Here, we compare various methods of tissue acquisition used in clinical practice and identify factors associated with inadequate sampling.Materials and methods Specimens submitted for NGS from a large single-centre UK academic institution following confirmation of lung cancer were reviewed. The primary objectives were to assess the proportion in which such analysis was successfully completed and identify factors, including the method of tissue acquisition, associated with sample inadequacy for, or failure of, the analysis. Secondary analyses included an assessment of genomic alterations identified by NGS-based analysis and specimen processing times.Results DNA-based NGS analysis was successfully completed in 87.1% (n=511/587) of all specimens, with known oncogenic driver variants being identified in 60.6% (n=310/511). Success rates for specific specimen acquisition techniques included 90.0% (n=126/140) for endobronchial ultrasound-guided transbronchial needle aspiration, 79.3% (n=88/111) for percutaneous image-guided lung biopsies, 66.7% (n=14/21) for pleural fluid cell blocks and 60% (n=9/15) for percutaneous image-guided pleural biopsies.Sequential RNA-based NGS analysis was successfully completed in 81.4% (n=92/113) cases, yielding a further 20 fusion gene events. Overall, actionable genomic alterations were identified in a total of 28.0% (n=143/511) of specimens across DNA-based and RNA-based analyses.Conclusion Pleural fluid cell blocks and percutaneous image-guided pleural biopsies were least likely to be associated with successful NGS-based processing. Where possible, other sites for tissue acquisition should be considered in individuals with pleural disease to prevent delays in their pathway.",
  "authors": [
    {
      "affiliations": [
        "Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK"
      ],
      "name": "Amyn Bhamani"
    },
    {
      "affiliations": [
        "Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK"
      ],
      "name": "Sindhu Bhaarrati Naidu"
    },
    {
      "affiliations": [
        "University College London Hospitals NHS Foundation Trust, London, UK"
      ],
      "name": "Naimish Adroja"
    },
    {
      "affiliations": [
        "University College London Hospitals NHS Foundation Trust, London, UK"
      ],
      "name": "Lucy Rogers"
    },
    {
      "affiliations": [
        "University College London Hospitals NHS Foundation Trust, London, UK"
      ],
      "name": "Lavanya Anandan"
    },
    {
      "affiliations": [
        "Sarah Cannon Molecular Diagnostics, HCA Healthcare UK, London, UK"
      ],
      "name": "Phil Bennett"
    },
    {
      "affiliations": [
        "University College London Hospitals NHS Foundation Trust, London, UK"
      ],
      "name": "Tanya Ahmad"
    },
    {
      "affiliations": [
        "University College London Hospitals NHS Foundation Trust, London, UK",
        "CRUK Lung Cancer Centre of Excellence, UCL Cancer Institute, London, UK"
      ],
      "name": "Martin D Forster"
    },
    {
      "affiliations": [
        "University College London Hospitals NHS Foundation Trust, London, UK"
      ],
      "name": "Asia Ahmed"
    },
    {
      "affiliations": [
        "University College London Hospitals NHS Foundation Trust, London, UK"
      ],
      "name": "Ricky Thakrar"
    },
    {
      "affiliations": [
        "Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK",
        "University College London Hospitals NHS Foundation Trust, London, UK"
      ],
      "name": "Sam M Janes"
    },
    {
      "affiliations": [
        "University College London Hospitals NHS Foundation Trust, London, UK",
        "CRUK Lung Cancer Centre of Excellence, UCL Cancer Institute, London, UK"
      ],
      "name": "David A Moore"
    },
    {
      "affiliations": [
        "Lungs for Living Research Centre, UCL Respiratory, University College London, London, UK",
        "University College London Hospitals NHS Foundation Trust, London, UK"
      ],
      "name": "Neal Navani"
    }
  ],
  "title": "Comparison of tissue acquisition techniques for Next-Generation Sequencing of non-small cell lung cancer (NSCLC)",
  "uid": "99d6430c-4b86-5ac0-9c79-41b24a2e5daf"
}