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Open AccessArticle

Usefulness of Two Independent DNA and RNA Tissue-Based Multiplex Assays for the Routine Care of Advanced NSCLC Patients

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Division of Medical Oncology, Hospital Clínic, 08036 Barcelona, Spain
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Translational Genomics and Targeted Therapeutics in Solid Tumors, Institut d’Investigacions Biomèdiques August Pi I Sunyer, 08036 Barcelona, Spain
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Unitat Funcional de Tumors Toràcics, Hospital Clínic, 08036 Barcelona, Spain
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Division of Pathology, Hospital Clínic, 08036 Barcelona, Spain
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Division of Medical Oncology, Instituto Oncologico Dr. Rosell, Teknon Hospital, 08028 Barcelona, Spain
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Division of Thoracic Radiology, Hospital Clínic Barcelona, 08036 Barcelona, Spain
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Division of Medical Oncology, Hospital General de Granollers, 08402 Barcelona, Spain
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Division of Medical Oncology, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain
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Molecular Biology Core Facility, Hospital Clínic, 08036 Barcelona, Spain
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Department of Medicine, University of Barcelona, 08036 Barcelona, Spain
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Laboratory of Oncology, Pangaea Oncology, Quirón Dexeus University Hospital, 08028 Barcelona, Spain
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Author to whom correspondence should be addressed.
Cancers 2020, 12(5), 1124; https://doi.org/10.3390/cancers12051124
Received: 3 April 2020 / Revised: 22 April 2020 / Accepted: 23 April 2020 / Published: 30 April 2020
Personalized medicine is nowadays a paradigm in lung cancer management, offering important benefits to patients. This study aimed to test the feasibility and utility of embedding two multiplexed genomic platforms as the routine workup of advanced non-squamous non-small cell lung cancer (NSCLC) patients. Two parallel multiplexed approaches were performed based on DNA sequencing and direct digital detection of RNA with nCounter® technology to evaluate gene mutations and fusions. The results were used to guide genotype-directed therapies and patient outcomes were collected. A total of 224 advanced non-squamous NSCLC patients were prospectively included in the study. Overall, 85% of samples were successfully characterized at DNA and RNA levels and oncogenic drivers were found in 68% of patients, with KRAS, EGFR, METΔex14, BRAF, and ALK being the most frequent (31%, 19%, 5%, 4%, and 4%, respectively). Among all patients with complete genotyping results and follow-up data (n = 156), the median overall survival (OS) was 1.90 years (confidence interval (CI) 95% 1.69–2.10) for individuals harbouring an actionable driver treated with a matched therapy, compared with 0.59 years (CI 95% 0.39–0.79) in those not eligible for any targeted therapy and 0.61 years (CI 95% 0.12–1.10) in patients with no drivers identified (p < 0.001). Integrating DNA and RNA multiplexing technologies into the routine molecular testing of advanced NSCLC patients is feasible and useful and highlights the necessity of widespread integrating comprehensive molecular diagnosis into lung cancer care. View Full-Text
Keywords: advanced non-small cell lung cancer; molecular diagnostics; oncogenic drivers; mutations; targeted therapies advanced non-small cell lung cancer; molecular diagnostics; oncogenic drivers; mutations; targeted therapies
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Marin, E.; Teixido, C.; Carmona-Rocha, E.; Reyes, R.; Arcocha, A.; Viñolas, N.; Rodríguez-Mues, M.; Cabrera, C.; Sánchez, M.; Vollmer, I.; Castillo, S.; Muñoz, S.; Sullivan, I.G.; Rodriguez, A.; Garcia, M.; Alos, S.; Jares, P.; Martinez, A.; Prat, A.; Molina-Vila, M.Á.; Reguart, N. Usefulness of Two Independent DNA and RNA Tissue-Based Multiplex Assays for the Routine Care of Advanced NSCLC Patients. Cancers 2020, 12, 1124.

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