title: Feasibility of image-guided transthoracic core-needle biopsy in the BATTLE lung trial.
abstract: BACKGROUND
  As therapy for non-small-cell lung cancer (NSCLC) patients becomes more personalized, additional tissue in the form of core-needle biopsies (CNBs) for biomarker analysis is increasingly required for determining appropriate treatment and for enrollment into clinical trials. We report our experience with small-caliber percutaneous transthoracic (PT) CNBs for the evaluation of multiple molecular biomarkers in BATTLE (biomarker-integrated approaches of targeted therapy for lung cancer elimination), a personalized, targeted therapy NSCLC clinical trial.
  
  
  METHODS
  The medical records of patients who underwent PTCNB for consideration of enrollment in BATTLE were reviewed for diagnostic yield of 11 predetermined molecular markers and procedural complications. Univariate and multivariate analyses of factors related to patient and lesion characteristics were performed to determine possible influences on diagnostic yield.
  
  
  RESULTS
  One hundred and seventy PTCNBs were performed using 20-gauge biopsy needles in 151 NSCLC patients screened for the trial. The biopsy specimens of 82.9% of the patients were found to have adequate tumor tissue for analysis of the required biomarkers. On multivariate analysis, metastatic lesions were 5.4 times more likely to yield diagnostic tissue as compared with primary tumors (p = 0.0079). Pneumothorax and chest tube insertion rates were 15.3% and 9.4%, respectively.
  
  
  CONCLUSIONS
  Image-guided 20-gauge PTCNB is safe and provides adequate tissue for analysis of multiple biomarkers in the majority of patients being considered for enrollment into a personalized, targeted therapy NSCLC clinical trial. Metastatic lesions are more likely to yield diagnostic tissue as compared with primary tumors.
authors: Department of Diagnostic Radiology, Unit 1471, The University of Texas, M.D. Anderson Cancer Center, PO Box 301402, Houston, TX 77230, USA. alda.tam@mdanderson.org
authors: Alda L
authors: AL
authors: Tam
authors: Edward S
authors: ES
authors: Kim
authors: J Jack
authors: JJ
authors: Lee
authors: Joe E
authors: JE
authors: Ensor
authors: Marshall E
authors: ME
authors: Hicks
authors: Ximing
authors: X
authors: Tang
authors: George R
authors: GR
authors: Blumenschein
authors: Christine M
authors: CM
authors: Alden
authors: Jeremy J
authors: JJ
authors: Erasmus
authors: Anne
authors: A
authors: Tsao
authors: Scott M
authors: SM
authors: Lippman
authors: Waun K
authors: WK
authors: Hong
authors: Ignacio I
authors: II
authors: Wistuba
authors: Sanjay
authors: S
authors: Gupta
mesh_terms: D000230:Adenocarcinoma / Q000235:genetics / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000235:genetics*; D001707:Biopsy, Needle; D002289:Carcinoma, Non-Small-Cell Lung / Q000235:genetics / Q000473:pathology / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000235:genetics / Q000473:pathology / Q000601:surgery; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D061705:Image-Guided Biopsy; D008175:Lung Neoplasms / Q000235:genetics / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D058990:Molecular Targeted Therapy; D009367:Neoplasm Staging; D057285:Precision Medicine; D011379:Prognosis; D013902:Radiography, Thoracic; D014057:Tomography, X-Ray Computed
chemical_list: D014408:Biomarkers, Tumor