title: Feasibility and clinical impact of re-biopsy in advanced non small-cell lung cancer: a prospective multicenter study in a real-world setting (GFPC study 12-01).
abstract: OBJECTIVE
  When advanced non-small-cell lung cancer (NSCLC) progresses during first-line treatment, re-biopsy may be indicated to detect a possible new biological profile (comparison to initial status, emergence of resistance biomarkers, or assessment of new biomarkers). The aim of this pragmatic prospective multicenter study was to assess the feasibility and clinical utility of re-biopsy in advanced NSCLC in a real-world setting.
  
  
  METHODS
  The main inclusion criteria were advanced NSCLC with an indication for repeat biopsy identified by the patient's clinician. The primary outcome was the percentage of successful procedures. Secondary outcomes were the type of procedure, new biological status, tolerability of the procedure, and clinical utility (treatment modification).
  
  
  RESULTS
  From May 2012 to May 2013, 18 centers enrolled 100 patients (males: 44%; median age: 64.8 years; PS 0/1: 88%; adenocarcinoma: 89%; EGFR mutated: 50%; no initial biological profile: 16.4%). Re-biopsy was not possible in 19.5% of cases and provided no or too few tumor cells in 25.6% of cases. Repeat biopsy was useful for guiding treatment in 30.4% (25/82) of cases. Complications were infrequent (2 cases of moderate bleeding and 1 case of pneumothorax).
  
  
  CONCLUSIONS
  Re-biopsy of advanced NSCLC is feasible in the real-world setting, with acceptable adverse events. Guidelines are needed on the indications of re-biopsy, the choice of procedure, the sampling site, and laboratory analysis.
authors.affiliation: Service de pneumologie APHP, Saint Antoine, Paris, France.
authors.forename: Christos
authors.initials: C
authors.lastname: Chouaid
authors.affiliation: CH Le Chesnay, France.
authors.forename: Cecile
authors.initials: C
authors.lastname: Dujon
authors.affiliation: CAC, Caen, France.
authors.forename: Pascal
authors.initials: P
authors.lastname: Do
authors.affiliation: CHI Creteil, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Monnet
authors.affiliation: CAC Marseille, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Madroszyk
authors.affiliation: CH Draguignan, France.
authors.forename: Herve
authors.initials: H
authors.lastname: Le Caer
authors.affiliation: CH Mantes la Jolie, France.
authors.forename: Jean Bernard
authors.initials: JB
authors.lastname: Auliac
authors.affiliation: HIA Toulon, France.
authors.forename: Henri
authors.initials: H
authors.lastname: Berard
authors.affiliation: CH Gap, France.
authors.forename: Pascal
authors.initials: P
authors.lastname: Thomas
authors.affiliation: CHU Rennes, France.
authors.forename: Herve
authors.initials: H
authors.lastname: Lena
authors.affiliation: CHU Brest, France.
authors.forename: Gilles
authors.initials: G
authors.lastname: Robinet
authors.affiliation: CHU Angers, France.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Baize
authors.affiliation: CH La Roche sur Yon, France.
authors.forename: Acya
authors.initials: A
authors.lastname: Bizieux-Thaminy
authors.affiliation: CH Cercy Pontoise, France.
authors.forename: Gislaine
authors.initials: G
authors.lastname: Fraboulet
authors.affiliation: CH Meaux, France.
authors.forename: Chrystele
authors.initials: C
authors.lastname: Locher
authors.affiliation: CH Aix en Provence, France.
authors.forename: Jacques
authors.initials: J
authors.lastname: Le Treut
authors.affiliation: CH Annecy-Genevois, Pringy, France.
authors.forename: Stephane
authors.initials: S
authors.lastname: Hominal
authors.affiliation: CHU Limoges, France. Electronic address: alain.vergnenegre@unilim.fr.
authors.forename: Alain
authors.initials: A
authors.lastname: Vergnenegre
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D002289:Carcinoma, Non-Small-Cell Lung / Q000235:genetics / Q000473:pathology*; D066246:ErbB Receptors / Q000235:genetics; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000235:genetics / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009154:Mutation; D009367:Neoplasm Staging; D011446:Prospective Studies; D011518:Proto-Oncogene Proteins / Q000235:genetics; D016283:Proto-Oncogene Proteins p21(ras); D012307:Risk Factors; D018631:ras Proteins / Q000235:genetics
chemical_list: C117307:KRAS protein, human; D011518:Proto-Oncogene Proteins; D066246:ErbB Receptors; D016283:Proto-Oncogene Proteins p21(ras); D018631:ras Proteins
keywords: Biomarkers; Clinical management; Guidelines; Non small cell lung cancer; Re-biopsy