title: Prognostic factors of successful on-purpose tumor biopsies in metastatic cancer patients included in the SHIVA prospective clinical trial.
abstract: OBJECTIVE
  To identify patient/tumor characteristics associated with success of biopsy in patients who received multiple lines of chemotherapy.
  
  
  METHODS
  Patients with refractory cancer from our center, who were included in a prospective randomized phase II trial comparing targeted therapies based on molecular profile of tumors versus conventional chemotherapy, were retrospectively included in this IRB-approved study. All patients had a biopsy of a tumor lesion performed during surgery, or using CT/palpation/endoscopic guidance. A biopsy was considered successful if the neoplastic cellularity was greater than 30%. Primary lesion, size and location of biopsied lesion, on-going chemotherapy and the differential attenuation between non-enhanced and venous phase (HU) for CT-guided biopsied lesions were recorded.
  
  
  RESULTS
  228 patients (age=59±15yo; M/F=1.9) were included. One hundred and sixty biopsies (72%) of the 221 biopsies performed were successful. Prognostic factors of biopsy success were: no ongoing chemotherapy, surgical or palpation-guided biopsy, lymph nodes/soft tissue location(P <0.01). Among the 221 performed biopsies, 122 (55%) were performed using CT guidance and 82 (67%) were successful. In this subgroup, biopsied lesions located in lymph nodes/soft tissue were associated with a higher success rate while lung location was associated with failure (P <0.01). The mean differential attenuation was significantly higher in lesions with a successful biopsy (P <0.001).
  
  
  CONCLUSIONS
  Success of biopsy was less frequent with CT guidance than with surgical or palpation-guided biopsy and was higher in soft tissues and lymph nodes than that in visceral metastasis. Ongoing chemotherapy decreased tumor cell content and consequently the success of the biopsy samples for molecular profiling.
authors.affiliation: Departement of Radiology and Nuclear Medecine, Institut Curie, Paris, France.
authors.forename: Emilie
authors.initials: E
authors.lastname: Desportes
authors.affiliation: Departement of Radiology and Nuclear Medecine, Institut Curie, Paris, France.
authors.forename: Mathilde
authors.initials: M
authors.lastname: Wagner
authors.affiliation: Department of Medical Oncology, Institut Curie, Paris, France.
authors.forename: Maud
authors.initials: M
authors.lastname: Kamal
authors.affiliation: Department of Pathology, Institut Curie, Paris, France.
authors.forename: Anne Vincent
authors.initials: AV
authors.lastname: Salomon
authors.affiliation: Department of Pathology, Institut Curie, Paris, France.
authors.forename: Gabrielle
authors.initials: G
authors.lastname: Deniziaut
authors.affiliation: Department of Genetic, Institut Curie, Paris, France.
authors.forename: Gaëlle
authors.initials: G
authors.lastname: Pierron
authors.affiliation: Department of Genetic, Institut Curie, Paris, France.
authors.forename: Etienne
authors.initials: E
authors.lastname: Rouleau
authors.affiliation: Department of ENT Surgery, Institut Curie, Paris, France.
authors.forename: Thomas
authors.initials: T
authors.lastname: Jouffroy
authors.affiliation: Department of Medical Oncology, Institut Curie, Paris, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Le Tourneau
authors.affiliation: Department of Biostatistics and Epidemiology & INSERM U1018 oncostat, Gustave Roussy Cancer Campus, Villejuif, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Paoletti
authors.affiliation: Departement of Radiology and Nuclear Medecine, Institut Curie, Paris, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Servois
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D001707:Biopsy, Needle / Q000379:methods*; D005260:Female; D006801:Humans; D061705:Image-Guided Biopsy / Q000379:methods*; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D058990:Molecular Targeted Therapy / Q000379:methods*; D009369:Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology*; D011379:Prognosis; D011446:Prospective Studies; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
chemical_list: D000970:Antineoplastic Agents
keywords: CT-guided biopsy; biopsy; cellularity; precision medicine; targeted therapies