title: Re-biopsy status among non-small cell lung cancer patients in Japan: A retrospective study.
abstract: Disease progression because of acquired resistance is common in advanced or metastatic epidermal growth factor receptor (EGFR)-mutation positive non-small cell lung cancer (NSCLC), despite initial response to EGFR-tyrosine kinase inhibitors (TKIs). In Japan, transbronchial tissue biopsy is the most common sampling method used for re-biopsy to identify patients eligible for treatment. We aimed to investigate the success rate of re-biopsy and re-biopsy status of patients with advanced or metastatic NSCLC completing first-line EGFR-TKI therapy.
  
  
  
  This was a retrospective, multi-center, Japanese study. The target patients in the study were EGFR mutation-positive NSCLC patients. The primary endpoint was the success rate (number of cases in which tumor cells were detected/total number of re-biopsies performed×100). Secondary endpoints included differences between the status of the first biopsy and that of the re-biopsy in the same patient population, and the details of cases in which re-biopsy could not be carried out. Re-biopsy-associated complications were also assessed.
  
  
  
  Overall, 395 patients were evaluated (median age 63 years), with adenocarcinoma being the most common tumor type. Re-biopsy was successful in 314 patients (79.5%). Compared with the sampling method at first biopsy, at re-biopsy, the surgical resection rate increased from 1.8% to 7.8%, and percutaneous tissue biopsy increased from 7.6% to 29.1%, suggesting the difficulty of performing re-biopsy. Approximately half of the patients had T790M mutations, which involved a Del19 mutation in 55.6% of patients and an L858R mutation in 43.0%. Twenty-three patients (5.8%) had re-biopsy- associated complications, most commonly pneumothorax.
  
  
  
  Success rate for re-biopsy in this study was approximately 80%. Our study sheds light on the re-biopsy status after disease progression in patients with advanced or metastatic NSCLC. This information is important to improve the selection of patients who may benefit from third-generation TKIs.
authors: National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan.
authors: Kaname
authors: K
authors: Nosaki
authors: Hyogo Cancer Center, Hyogo, Japan.
authors: Miyako
authors: M
authors: Satouchi
authors: Kansai Medical University Hospital, Osaka, Japan.
authors: Takayasu
authors: T
authors: Kurata
authors: Aichi Cancer Center Hospital, Nagoya, Japan.
authors: Tatsuya
authors: T
authors: Yoshida
authors: Kyushu University Hospital, Fukuoka, Japan.
authors: Isamu
authors: I
authors: Okamoto
authors: Institute of Biomedical Research and Innovation, Kobe, Japan.
authors: Nobuyuki
authors: N
authors: Katakami
authors: Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
authors: Fumio
authors: F
authors: Imamura
authors: Kindai University, Faculty of Medicine, Osaka, Japan.
authors: Kaoru
authors: K
authors: Tanaka
authors: Saitama Cancer Center, Saitama, Japan.
authors: Yuki
authors: Y
authors: Yamane
authors: Wakayama Medical University, Wakayama, Japan.
authors: Nobuyuki
authors: N
authors: Yamamoto
authors: Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan (Kanagawa Cancer Center, since April 2016）.
authors: Terufumi
authors: T
authors: Kato
authors: Okayama University Hospital, Okayama, Japan.
authors: Katsuyuki
authors: K
authors: Kiura
authors: Nagoya Medical Center, Nagoya, Japan.
authors: Hideo
authors: H
authors: Saka
authors: Kurashiki Central Hospital, Kurashiki, Japan.
authors: Hiroshige
authors: H
authors: Yoshioka
authors: Miyagi Cancer Center, Natori, Japan.
authors: Kana
authors: K
authors: Watanabe
authors: Kagoshima University Hospital, Kagoshima, Japan.
authors: Keiko
authors: K
authors: Mizuno
authors: National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan. Electronic address: tseto@nk-cc.go.jp.
authors: Takashi
authors: T
authors: Seto
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000235:genetics / Q000473:pathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001706:Biopsy / Q000379:methods*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy / Q000235:genetics / Q000473:pathology*; D018450:Disease Progression; D019008:Drug Resistance, Neoplasm / Q000235:genetics*; D066246:ErbB Receptors / Q000378:metabolism; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008168:Lung / Q000187:drug effects / Q000473:pathology*; D008175:Lung Neoplasms / Q000188:drug therapy / Q000235:genetics / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009154:Mutation; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use; D012189:Retrospective Studies
chemical_list: D000970:Antineoplastic Agents; D047428:Protein Kinase Inhibitors; C512478:EGFR protein, human; D066246:ErbB Receptors
keywords: Epidermal growth factor receptor mutation; Non-small cell lung cancer; Re-biopsy; Resistance; T790 M; Tyrosine kinase inhibitor