KEY TAKEAWAYS
- The study aimed to describe the technique of tissue acquisition for CMP in pancreatic cancer.
- The primary outcome measure assessed the proportion of specimens from which sufficient DNA and RNA were extracted for CMP.
- The study found that 2 passes with 22G Franseen needles using fanning and style-retraction techniques can procure high-quality CMP specimens in pancreatic cancer pts.
Pancreatic cancer is a deadly disease with genomic lesions that can impact clinical management. Endoscopic ultrasound (EUS) fine-needle biopsy-(FNB) is an established method for diagnosis, but the technique for comprehensive molecular profiling (CMP) has not been described.
Researchers aimed to describe the technique of tissue acquisition for CMP in pancreatic cancer.
Pts with confirmed pancreatic adenocarcinoma through rapid onsite evaluation (ROSE) during EUS were randomly assigned to undergo two or three focused FNB passes for CMP. Tissue was acquired using a 22G Franseen needle, utilizing the fanning technique and stylet-retraction maneuver. Genomic DNA and total RNA were extracted from formalin-fixed paraffin-embedded (FFPE) cell blocks using Qiagen AllPrep. Next-generation sequencing (NGS) with Archer Panels was conducted to analyze DNA mutations (single nucleotide variants, insertions, and deletions) in 69 genes and RNA somatic oncogenic gene fusions in 53 genes. The primary outcome measure assessed the proportion of specimens from which sufficient DNA and RNA were extracted for CMP.
The study included 33 pts (mean age 77.0 years [SD 7.7], 20 female), who were randomized to either two (n = 17) or three (n = 16) FNB passes. DNA extraction was successful in all 33 FFPE cell blocks, while RNA extraction yielded adequate results in 93.8% of the three-pass group and 94.1% of the two-pass group (P= 0.99). There were no significant differences in the mean concentrations of DNA (two passes 10.7 ng/ul [SD 7.1] vs. three passes 7.9 ng/ul [SD 4.4]; P= 0.19) or RNA (two passes 37.1 ng/ul [SD 26.5] vs. three passes 28.9 ng/ul [SD 13.2]; P= 0.29) between these two groups. One specimen showed a somatic oncogene RNA fusion (LDAH-ETV1) associated with metastatic disease. DNA mutations were identified in all 33 specimens, including one BRCA1 mutation that indicated the need for oxaliplatin-based chemotherapy.
The study found that 2 passes with 22G Franseen needles using fanning and style-retraction techniques can procure high-quality CMP specimens in pancreatic cancer pts.
Source: https://ascopubs.org/doi/abs/10.1200/JCO.2023.41.16_suppl.e16306
Clinical Trial: https://classic.clinicaltrials.gov/ct2/show/NCT05043532
Ji Young Bang, Nirag Jhala, Anjali Seth, Konrad Krall, Udayakumar Navaneethan, Robert Hawes, C. Mel Wilcox, and Shyam Varadarajulu. DOI:10.1200/JCO.2023.41.16_suppl.e16306 Journal of Clinical Oncology 41, no. 16_suppl (June 01, 2023) e16306-e16306.
