Evidence map›Paper›PMID 39083479›Full record

Observational studyPloS one2024

Optimising primary molecular profiling in non-small cell lung cancer.

R D Schouten, I Schouten, M M F Schuurbiers, V van der Noort, R A M Damhuis, E H F M van der Heijden, J A Burgers, N P Barlo, A S R van Lindert, K W Maas and 10 more

Abstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in PloS one, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Observational
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

R D SchoutenDepartment of Thoracic Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands.ORCID 0000-0002-7014-470X
I SchoutenDepartment of Thoracic Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands.
M M F SchuurbiersDepartment of Pulmonology, Radboud University Medical Centre, Nijmegen, The Netherlands.ORCID 0000-0002-0843-8897
V van der NoortDepartment of Thoracic Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands.ORCID 0000-0002-4910-4535
R A M DamhuisIntegraal Kankercentrum Nederland (IKNL), Utrecht, The Netherlands.
E H F M van der HeijdenDepartment of Pulmonology, Radboud University Medical Centre, Nijmegen, The Netherlands.ORCID 0000-0003-3596-518X
J A BurgersDepartment of Thoracic Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands.ORCID 0000-0002-0218-8436
N P BarloPulmonology, Noordwest Ziekenhuis Groep, Alkmaar, The Netherlands.
A S R van LindertDepartment of Pulmonology, University Medical Centre Utrecht, Utrecht, The Netherlands.
K W MaasDepartment of Pulmonology, Haaglanden Medical Centre, The Hague, The Netherlands.
J J G van den BrandDepartment of Pulmonology, Meander Medical Centre, Amersfoort, The Netherlands.
A A J SmitDepartment of Pulmonology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.
J M W van HaarstDepartment of Pulmonology, Tergooi Ziekenhuizen, Hilversum, The Netherlands.
B van der MaatDepartment of Pulmonology, Flevoziekenhuis, Almere, The Netherlands.ORCID 0000-0002-9646-6811
E SchuuringDepartment of Pathology, University Medical Centre Groningen, Groningen, The Netherlands.ORCID 0000-0003-3655-143X
H BlaauwgeersDepartment of Pathology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.
S M WillemsDepartment of Pathology, University Medical Centre Groningen, Groningen, The Netherlands.
K MonkhorstDepartment of Pathology, Netherlands Cancer Institute, Amsterdam, The Netherlands.
D van den BroekDepartment of Clinical Chemistry, Netherlands Cancer Institute, Amsterdam, The Netherlands.ORCID 0000-0002-0514-9811
M M van den HeuvelDepartment of Thoracic Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands.ORCID 0000-0002-6372-2153

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionMolecular profiling of NSCLC is essential for optimising treatment decisions, but often incomplete. We assessed the efficacy of protocolised molecular profiling in the current standard-of-care (SoC) in a prospective observational study in the Netherlands and measured the effect of providing standardised diagnostic procedures. We also explored the potential of plasma-based molecular profiling in the primary diagnostic setting.

methodsThis multi-centre prospective study was designed to explore the performance of current clinical practice during the run-in phase using local SoC tissue profiling procedures. The subsequent phase was designed to investigate the extent to which comprehensive molecular profiling (CMP) can be maximized by protocolising tumour profiling. Successful molecular profiling was defined as completion of at least EGFR and ALK testing. Additionally, PD-L1 tumour proportions scores were explored. Lastly, the additional value of centralised plasma-based testing for EGFR and KRAS mutations using droplet digital PCR was evaluated.

resultsTotal accrual was 878 patients, 22.0% had squamous cell carcinoma and 78.0% had non-squamous NSCLC. Stage I-III was seen in 54.0%, stage IV in 46.0%. Profiling of EGFR and ALK was performed in 69.9% of 136 patients included in the run-in phase, significantly more than real-world data estimates of 55% (p<0.001). Protocolised molecular profiling increased the rate to 77.0% (p = 0.049). EGFR and ALK profiling rates increased from 77.9% to 82.1% in non-squamous NSCLC and from 43.8% to 57.5% in squamous NSCLC. Plasma-based testing was feasible in 98.4% and identified oncogenic driver mutations in 7.1% of patients for whom tissue profiling was unfeasible.

conclusionThis study shows a high success rate of tissue-based molecular profiling that was significantly improved by a protocolised approach. Tissue-based profiling remains unfeasible for a substantial proportion of patients. Combined analysis of tumour tissue and circulating tumour DNA is a promising approach to allow adequate molecular profiling of more patients.

Indexed as

Carcinoma, Non-Small-Cell LungLung NeoplasmsAdultAgedAged, 80 and overAnaplastic Lymphoma KinaseB7-H1 AntigenBiomarkers, TumorErbB ReceptorsFemaleGene Expression ProfilingHumansMaleMiddle AgedMutationNetherlandsALK protein, humanAnaplastic Lymphoma KinaseB7-H1 AntigenBiomarkers, TumorEGFR protein, humanErbB ReceptorsKRAS protein, humanProto-Oncogene Proteins p21(ras)

Identifiers

PMID39083479
PMCPMC11290658

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.