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Acosta-Medina AA, Abeykoon JP, Go RS, Goyal G, Ravindran A, Schram SM, Rech KL. BRAF testing modalities in histiocytic disorders: Comparative analysis and proposed testing algorithm. Am J Clin Pathol 2023; 160:483-489. [PMID: 37458275 DOI: 10.1093/ajcp/aqad076] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 06/01/2023] [Indexed: 11/08/2023] Open
Abstract
OBJECTIVES Understanding of histiocytic disorders has been revolutionized by demonstration of mitogen-activated protein kinase (MAPK) pathway mutations, most commonly BRAFV600E. The optimal testing strategy to assess BRAFV600E is unknown. We aimed to compare performance of testing modalities, to propose a framework for evaluation of BRAFV600E mutation status in histiocytic disorders. METHODS We retrospectively reviewed patients with histiocytic disorders and BRAF mutation testing on a lesional tissue specimen. RESULTS In 120 patients, BRAF assessment included immunohistochemistry (IHC) in 97 (80.2%), polymerase chain reaction (PCR) in 35 (28.9%), and next-generation sequencing (NGS) in 62 (51.2%). Forty-five underwent both NGS and IHC. With NGS as the gold standard, the sensitivity and specificity of IHC were 82.4% and 96.4%. Three false negatives were observed in biopsy specimens with low BRAFV600E variant allele frequency or decalcified tissue. One false-positive IHC was observed in a lung biopsy specimen, likely due to antibody cross-reactivity with respiratory cilia. Among 14 with successful NGS and PCR, a single discordance was observed. Two PCR-to-IHC discrepancies were observed, including one other false-positive IHC. CONCLUSIONS Immunohistochemistry was highly specific for detection of BRAFV600E. Main caveats were false negatives and lack of detection of non-BRAFV600E mutations. We propose the use of IHC as initial screening in general practice with reflex molecular testing if negative.
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Affiliation(s)
| | | | - Ronald S Go
- Division of Hematology, Mayo Clinic, Rochester, MN, US
| | - Gaurav Goyal
- Division of Hematology-Oncology and University of Alabama at Birmingham, Birmingham, AL, US
| | - Aishwarya Ravindran
- Division of Laboratory Medicine, University of Alabama at Birmingham, Birmingham, AL, US
| | | | - Karen L Rech
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, US
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2
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Yakout NM, Abdallah DM, Abdelmonsif DA, Kholosy HM, Talaat IM, Elsakka O. BRAF V600E mutational status assessment in cutaneous melanocytic neoplasms in a group of the Egyptian population. Cancer Cell Int 2023; 23:17. [PMID: 36737739 PMCID: PMC9896695 DOI: 10.1186/s12935-023-02858-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 01/24/2023] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Melanocytic neoplasms range from banal nevi to malignant melanomas. The genetic background has been extensively studied in the Caucasian population. BRAF mutations were reported among the early driver mutations in nevogenesis. Nevertheless, the pathogenesis in the Egyptian population has not been elucidated. AIM AND METHODS The present study was carried out to assess the sensitivity and specificity of immunohistochemistry (IHC) using the RM-08 clone in reference to allele-specific real-time PCR (CAST-PCR) for the detection of the BRAF V600E mutation in 50 formalin-fixed paraffin-embedded blocks of melanocytic neoplasms with prior bleaching using hydrogen peroxide in Tris-HCL and Bovine Serum Albumin respectively. RESULTS IHC staining was interpreted using staining reaction (positive versus negative) and staining pattern (negative and heterogeneous versus homogenous). Using the staining pattern, the specificity increased from 73.3 to 88.2%, the negative predictive value increased from 73.3 to 100%, the diagnostic accuracy increased from 71.4 to 90.48% and the overall accuracy increased from 69.9 to 77.3%. The sensitivity and positive predictive value remained unchanged. The K-agreement coefficient increased from 0.364 (fair agreement) to 0.741 (good agreement) and was statistically significant (p = 0.00). Next-generation sequencing was performed in 11 cases, 8 cases with IHC-positive and BRAF wild type in addition to 3 cases that failed PCR analysis and revealed no BRAF V600E. No statistically significant difference was found in the clinicopathological parameters between BRAF V600E and BRAF wild-type melanomas. CONCLUSIONS These findings suggest that IHC staining homogeneity may be more accurate in predicting BRAF V600E mutational status. However, IHC cannot replace molecular methods.
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Affiliation(s)
- Nada M. Yakout
- grid.7155.60000 0001 2260 6941Pathology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Dina M. Abdallah
- grid.7155.60000 0001 2260 6941Pathology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Doaa A. Abdelmonsif
- grid.7155.60000 0001 2260 6941Medical Biochemistry Department, Genomics Research Lab, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Hassan Mahmoud Kholosy
- grid.7155.60000 0001 2260 6941Department of Plastic Surgery, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Iman M. Talaat
- grid.7155.60000 0001 2260 6941Pathology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt ,grid.412789.10000 0004 4686 5317Clinical Sciences Department, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Omayma Elsakka
- grid.7155.60000 0001 2260 6941Pathology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
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3
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Comparison of Two Rapid Assays for the Detection of BRAF V600 Mutations in Metastatic Melanoma including Positive Sentinel Lymph Nodes. Diagnostics (Basel) 2022; 12:diagnostics12030751. [PMID: 35328303 PMCID: PMC8947166 DOI: 10.3390/diagnostics12030751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 03/17/2022] [Accepted: 03/18/2022] [Indexed: 02/01/2023] Open
Abstract
Testing for the BRAF mutation is mandatory for the management of patients with locally advanced or metastatic melanoma. Molecular analysis based on DNA sequencing remains the gold-standard method for the screening of the different BRAF mutations. These methods must be rapid, sensitive, and specific enough to allow optimal therapeutic management in daily practice and also to include patients in clinical trials. Here, we compared the Idylla BRAF Mutation Test and the anti-BRAF V600E (clone VE1) immunohistochemistry (IHC) in 90 melanoma samples, with a focus on a challenging cohort of 32 positive sentinel lymph nodes. The BRAF status was assessed with both methods independently of the percentage of tumor cells. The concordance rate was calculated excluding both non-contributory analyses and BRAFV600K/R/M mutants due to the specific V600E-IHC test design. The incidence of the BRAFV600E mutation was 33% with both BRAF Idylla and BRAF IHC. The agreement rate was 91% (72/79). Although the agreement rate was high, we suggest that the use of IHC is more suitable for rapid BRAF testing on sentinel lymph node biopsies when associated with a low percentage and scattered tumor cells, which gave a high risk of non-contributory analysis and/or false negative results with the IdyllaTMBRAF Mutation Test.
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4
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Kamata M, Minamisaka T, Imura J, Saitoh K, Shimomura A, Noguchi A. A Case of Dedifferentiated Melanoma With Lymph Node Metastasis Where Molecular Biological Tests Were Useful for Diagnosis. Cureus 2022; 14:e21644. [PMID: 35233321 PMCID: PMC8881242 DOI: 10.7759/cureus.21644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2022] [Indexed: 11/05/2022] Open
Abstract
Malignant melanoma is known to have an altered phenotype and loss of differentiation markers for melanoma due to metastasis. Here, we report a case in which the expression of the immunohistochemical markers for melanoma was changed due to lymph node metastasis of primary cutaneous malignant melanoma. The patient, a male in his 60s, was diagnosed with malignant melanoma after undergoing excision of a skin mass. The additional excision specimen showed a small number of tumor cell clusters infiltrating the dermis. The biopsied lymph node showed completely different histological findings from those of the skin lesion and consisted of spindle-shaped tumor cells. An immunohistochemical study revealed no significant positive reactions in the lymph node tissue indicative of melanoma. The additional genetic study revealed BRAF V600e mutations in both the primary tumor and a lymph node. Together with the histological findings, the diagnosis was of metastasis of dedifferentiated melanoma to a lymph node. In summary, there is a risk of underestimation or misdiagnosis of melanoma as undifferentiated sarcoma or other tumors when melanoma metastasizes to lymph nodes and findings show a dedifferentiated or undifferentiated tumor. Therefore, as in this case, it is necessary to add a genetic study in order to make a comprehensive judgment.
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5
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Bourhis A, Remoué A, Samaison L, Uguen A. Diagnostic mutationnel rapide Idylla™ : applications théranostiques actuelles et futures. Ann Pathol 2022; 42:329-343. [DOI: 10.1016/j.annpat.2021.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 12/07/2021] [Accepted: 12/12/2021] [Indexed: 10/19/2022]
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6
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Berrino E, Balsamo A, Pisacane A, Gallo S, Becco P, Miglio U, Caravelli D, Poletto S, Paruzzo L, Debernardi C, Piccinelli C, Zaccagna A, Rescigno P, Aglietta M, Sapino A, Carnevale-Schianca F, Venesio T. High BRAF variant allele frequencies are associated with distinct pathological features and responsiveness to target therapy in melanoma patients. ESMO Open 2021; 6:100133. [PMID: 33984673 PMCID: PMC8134716 DOI: 10.1016/j.esmoop.2021.100133] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 03/02/2021] [Accepted: 04/08/2021] [Indexed: 12/20/2022] Open
Abstract
Background BRAF mutant melanoma patients are commonly treated with anti-BRAF therapeutic strategies. However, many factors, including the percentage of BRAF-mutated cells, may contribute to the great variability in patient outcomes. Patients and methods The BRAF variant allele frequency (VAF; defined as the percentage of mutated alleles) of primary and secondary melanoma lesions, obtained from 327 patients with different disease stages, was assessed by pyrosequencing. The BRAF mutation rate and VAF were then correlated with melanoma pathological features and patients’ clinical characteristics. Kaplan–Meier curves were used to study the correlations between BRAF VAF, overall survival (OS), and progression-free survival (PFS) in a subset of 62 patients treated by anti-BRAF/anti-MEK therapy after metastatic progression. Results A highly heterogeneous BRAF VAF was identified (3%-90%). Besides being correlated with age, a higher BRAF VAF level was related to moderate lymphocytic infiltration (P = 0.017), to melanoma thickness according to Clark levels, (level V versus III, P = 0.004; level V versus IV, P = 0.04), to lymph node metastases rather than cutaneous (P = 0.04) or visceral (P = 0.03) secondary lesions. In particular, a BRAF VAF >25% was significantly associated with a favorable outcome in patients treated with the combination of anti-BRAF/anti-MEK drug (OS P = 0.04; PFS P = 0.019), retaining a significant value as an independent factor for the OS and the PFS in the multivariate analysis (P = 0.014 and P = 0.003, respectively). Conclusion These results definitively support the role of the BRAF VAF as a potential prognostic and predictive biomarker in melanoma patients in the context of BRAF inhibition. In melanoma the response to anti-BRAF targeted therapies is heterogeneous and influenced by several features. The role of the BRAF VAF as provider of sensitivity to target therapies is debated. We found that high BRAF VAFs are associated with patient age, melanoma thickness, non-brisk TILs and lymph node metastases. We proved the independent prognostic value of high BRAF VAFs in melanoma patients treated with targeted therapies. The quantitative evaluation of BRAF mutations allows stratifying melanoma patients to the BRAF/MEK targeted treatment.
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Affiliation(s)
- E Berrino
- Pathology Unit, Candiolo Cancer Institute, FPO-IRCCs, Turin, Italy; Department of Medical Sciences, University of Turin, Turin, Italy
| | - A Balsamo
- Clinical Research Office, Candiolo Cancer Institute, FPO-IRCCs, Turin, Italy
| | - A Pisacane
- Pathology Unit, Candiolo Cancer Institute, FPO-IRCCs, Turin, Italy
| | - S Gallo
- Medical Oncology Division, Candiolo Cancer Institute, FPO-IRCCs, Turin, Italy
| | - P Becco
- Medical Oncology Division, Candiolo Cancer Institute, FPO-IRCCs, Turin, Italy
| | - U Miglio
- Pathology Unit, Candiolo Cancer Institute, FPO-IRCCs, Turin, Italy
| | - D Caravelli
- Medical Oncology Division, Candiolo Cancer Institute, FPO-IRCCs, Turin, Italy
| | - S Poletto
- Medical Oncology Division, Candiolo Cancer Institute, FPO-IRCCs, Turin, Italy; Department of Oncology, University of Turin, Turin, Italy
| | - L Paruzzo
- Medical Oncology Division, Candiolo Cancer Institute, FPO-IRCCs, Turin, Italy; Department of Oncology, University of Turin, Turin, Italy
| | - C Debernardi
- Pathology Unit, Candiolo Cancer Institute, FPO-IRCCs, Turin, Italy
| | - C Piccinelli
- Pathology Unit, Candiolo Cancer Institute, FPO-IRCCs, Turin, Italy
| | - A Zaccagna
- Dermosurgery, Candiolo Cancer Institute, FPO-IRCCs, Turin, Italy
| | - P Rescigno
- Interdisciplinary Group for Research and Clinical Trials, Candiolo Cancer Institute, FPO-IRCCs, Turin, Italy
| | - M Aglietta
- Medical Oncology Division, Candiolo Cancer Institute, FPO-IRCCs, Turin, Italy; Department of Oncology, University of Turin, Turin, Italy
| | - A Sapino
- Pathology Unit, Candiolo Cancer Institute, FPO-IRCCs, Turin, Italy; Department of Medical Sciences, University of Turin, Turin, Italy.
| | | | - T Venesio
- Pathology Unit, Candiolo Cancer Institute, FPO-IRCCs, Turin, Italy.
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7
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Funck-Brentano E, Malissen N, Roger A, Lebbé C, Deilhes F, Frénard C, Dréno B, Meyer N, Grob JJ, Tétu P, Saiag P. Which adjuvant treatment for patients with BRAF V600-mutant cutaneous melanoma? Ann Dermatol Venereol 2021; 148:145-155. [PMID: 33579557 DOI: 10.1016/j.annder.2020.11.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 10/22/2020] [Accepted: 11/05/2020] [Indexed: 12/21/2022]
Abstract
Treatment of patients with melanoma has considerably improved over the past decade and more recently with adjuvant therapies for patients with American Joint Committee on Cancer (AJCC) stage III (loco-regional metastases) or IV (distant metastases) totally resected melanoma, in order to prevent recurrence. In the adjuvant setting, two options are available to patients with BRAFV600-mutant AJCC stage III totally resected melanoma: anti-PD-1 blockers (nivolumab or pembrolizumab) or BRAF plus MEK inhibitors (dabrafenib plus trametinib). In the absence of comparative studies, it is difficult to determine which of these options is best. Our aim was to review published studies focusing on the management of patients with BRAFV600-mutant melanoma in the adjuvant setting. We also reviewed the main clinical trials of BRAF plus MEK inhibitors and immunotherapy in advanced (i.e. unresectable metastatic) BRAF-mutant melanoma in an attempt to identify results potentially affecting the management of patients on adjuvants. More adverse events are observed with targeted therapy, but all resolve rapidly upon drug discontinuation, whereas with immune checkpoint blockers some adverse events may persist. New therapeutic strategies are emerging, notably neoadjuvant therapies for stage III patients and adjuvant therapies for stage II patients; the place of the adjuvant strategy amidst all these options will soon be re-evaluated. The choice of adjuvant treatment could influence the choice of subsequent treatments in neo-adjuvant or metastatic settings. This review will lead clinicians to a better understanding of the different adjuvant treatments available for patients with totally resected AJCC stage III and IV BRAFV600-mutant melanoma before considering subsequent treatment strategies.
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Affiliation(s)
- E Funck-Brentano
- Department of General and Oncologic Dermatology, Ambroise-Paré hospital, AP-HP, Boulogne-Billancourt, France; Research unit EA4340 "Biomarkers and clinical trials in oncology and onco-hematology", Versailles-Saint-Quentin-en-Yvelines University, Paris-Saclay University, France.
| | - N Malissen
- Department of Dermatology and Skin Cancer, Aix-Marseille University, AP-HM, Hôpital Timone, Marseille, France
| | - A Roger
- Department of General and Oncologic Dermatology, Ambroise-Paré hospital, AP-HP, Boulogne-Billancourt, France; Research unit EA4340 "Biomarkers and clinical trials in oncology and onco-hematology", Versailles-Saint-Quentin-en-Yvelines University, Paris-Saclay University, France
| | - C Lebbé
- Inserm U976, Department of Dermatology, Dermatology, Paris University, Hôpital Saint-Louis, AP-HP, Paris, France
| | - F Deilhes
- Dermatology Department, CHU de Toulouse, Toulouse, France
| | - C Frénard
- Department of Dermatology, CRCINA, CIC1413, CHU de Nantes, université de Nantes, Nantes, France
| | - B Dréno
- Department of Dermatology, CRCINA, CIC1413, CHU de Nantes, université de Nantes, Nantes, France
| | - N Meyer
- Dermatology Department, CHU de Toulouse, Toulouse, France
| | - J-J Grob
- Department of Dermatology and Skin Cancer, Aix-Marseille University, AP-HM, Hôpital Timone, Marseille, France
| | - P Tétu
- Department of Dermatology, CRCINA, CIC1413, CHU de Nantes, université de Nantes, Nantes, France
| | - P Saiag
- Department of General and Oncologic Dermatology, Ambroise-Paré hospital, AP-HP, Boulogne-Billancourt, France; Research unit EA4340 "Biomarkers and clinical trials in oncology and onco-hematology", Versailles-Saint-Quentin-en-Yvelines University, Paris-Saclay University, France
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8
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Comparison of BRAF Mutation Screening Strategies in a Large Real-Life Series of Advanced Melanoma Patients. J Clin Med 2020; 9:jcm9082430. [PMID: 32751423 PMCID: PMC7464760 DOI: 10.3390/jcm9082430] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 07/23/2020] [Accepted: 07/27/2020] [Indexed: 11/20/2022] Open
Abstract
Malignant melanoma (MM) is one of the deadliest skin cancers. BRAF mutation status plays a predominant role in the management of MM patients. The aim of this study was to compare BRAF mutational testing performed by conventional nucleotide sequencing approaches with either real-time polymerase chain reaction (rtPCR) or next-generation sequencing (NGS) assays in a real-life, hospital-based series of advanced MM patients. Consecutive patients with AJCC (American Joint Committee on Cancer) stage IIIC and IV MM from Sardinia, Italy, who were referred for molecular testing, were enrolled into the study. Initial screening was performed to assess the mutational status of the BRAF and NRAS genes, using the conventional methodologies recognized by the nationwide guidelines, at the time of the molecular classification, required by clinicians: at the beginning, Sanger-based sequencing (SS) and, after, pyrosequencing. The present study was then focused on BRAF mutation detecting approaches only. BRAF wild-type cases with available tissue and adequate DNA were further tested with rtPCR (Idylla™) and NGS assays. Globally, 319 patients were included in the study; pathogenic BRAF mutations were found in 144 (45.1%) cases examined with initial screening. The rtPCR detected 11 (16.2%) and 3 (4.8%) additional BRAF mutations after SS and pyrosequencing, respectively. NGS detected one additional BRAF-mutated case (2.1%) among 48 wild-type cases previously tested with pyrosequencing and rtPCR. Our study evidenced that rtPCR and NGS were able to detect additional BRAF mutant cases in comparison with conventional sequencing methods; therefore, we argue for the preferential utilization of the aforementioned assays (NGS and rtPCR) in clinical practice, to eradicate false-negative cases and improve the accuracy of BRAF detection.
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9
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Vanni I, Tanda ET, Spagnolo F, Andreotti V, Bruno W, Ghiorzo P. The Current State of Molecular Testing in the BRAF-Mutated Melanoma Landscape. Front Mol Biosci 2020; 7:113. [PMID: 32695793 PMCID: PMC7338720 DOI: 10.3389/fmolb.2020.00113] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 05/13/2020] [Indexed: 01/19/2023] Open
Abstract
The incidence of melanoma, among the most lethal cancers, is widespread and increasing. Metastatic melanoma has a poor prognosis, representing about 90% of skin cancer mortality. The increased knowledge of tumor biology and the greater understanding of the immune system role in the anti-tumor response has allowed us to develop a more rational approach to systemic therapies. The discovery of activating BRAF mutations in half of all melanomas has led to the development of molecularly targeted therapy with BRAF and MEK inhibitors, which dramatically improved outcomes of patients with stage IV BRAF-mutant melanoma. More recently, the results of clinical phase III studies conducted in the adjuvant setting led to the combined administration of BRAF and MEK inhibitors also in patients with resected high-risk melanoma (stage III). Therefore, BRAF mutation testing has become a priority to determine the oncologist's choice and course of therapy. In this review, we will report the molecular biology-based strategies used for BRAF mutation detection with the main advantages and disadvantages of the most commonly used diagnostic strategies. The timing of such molecular assessment in patients with cutaneous melanoma will be discussed, and we will also examine considerations and approaches for accurate and effective BRAF testing.
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Affiliation(s)
- Irene Vanni
- Genetics of Rare Cancers, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Genetics of Rare Cancers, Department of Internal Medicine and Medical Specialties, University of Genoa, Genoa, Italy
| | | | | | - Virginia Andreotti
- Genetics of Rare Cancers, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Genetics of Rare Cancers, Department of Internal Medicine and Medical Specialties, University of Genoa, Genoa, Italy
| | - William Bruno
- Genetics of Rare Cancers, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Genetics of Rare Cancers, Department of Internal Medicine and Medical Specialties, University of Genoa, Genoa, Italy
| | - Paola Ghiorzo
- Genetics of Rare Cancers, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Genetics of Rare Cancers, Department of Internal Medicine and Medical Specialties, University of Genoa, Genoa, Italy
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10
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Detection of Gene Mutations in Liquid Biopsy of Melanoma Patients: Overview and Future Perspectives. Curr Treat Options Oncol 2020; 21:19. [PMID: 32048063 DOI: 10.1007/s11864-020-0708-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OPINION STATEMENT Liquid biopsies are still far from widely implanted in the clinical arena. Issues related to the added sensitivity of this test beyond conventional methods have not been fully resolved. Additionally, issues related to the specificity of these results especially as many cancers may share common mutation need further investigations. One way to resolve this may include the development and testing of large gene panels to add higher specificity. On the other hand, further studies are needed to support the idea that ctDNA or circulating tumor cells may constitute a better representation of the tumor subpopulation that is capable of metastasizing, which will strongly support its clinical value. Finally, survival studies showing a positive impact of this technology will also justify its widespread implementation in clinical practice.
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11
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Seto K, Haneda M, Masago K, Fujita S, Kato S, Sasaki E, Hosoda W, Murakami Y, Kuroda H, Horio Y, Hida T, Okubo K, Yatabe Y. Negative reactions ofBRAFmutation‐specific immunohistochemistry tonon‐V600Emutations ofBRAF. Pathol Int 2020; 70:253-261. [DOI: 10.1111/pin.12903] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 12/30/2019] [Indexed: 12/13/2022]
Affiliation(s)
- Katsutoshi Seto
- Department of Pathology and Molecular DiagnosticsAichi Cancer Center Hospital Aichi Japan
- Department of Thoracic SurgeryTokyo Medical and Dental University Tokyo Japan
| | - Masataka Haneda
- Department of Pathology and Molecular DiagnosticsAichi Cancer Center Hospital Aichi Japan
| | - Katsuhiro Masago
- Department of Pathology and Molecular DiagnosticsAichi Cancer Center Hospital Aichi Japan
| | - Shiro Fujita
- Department of Pathology and Molecular DiagnosticsAichi Cancer Center Hospital Aichi Japan
| | - Seiichi Kato
- Department of Pathology and Molecular DiagnosticsAichi Cancer Center Hospital Aichi Japan
| | - Eiichi Sasaki
- Department of Pathology and Molecular DiagnosticsAichi Cancer Center Hospital Aichi Japan
| | - Waki Hosoda
- Department of Pathology and Molecular DiagnosticsAichi Cancer Center Hospital Aichi Japan
| | - Yoshiko Murakami
- Department of Pathology and Molecular DiagnosticsAichi Cancer Center Hospital Aichi Japan
| | - Hiroaki Kuroda
- Department of Thoracic SurgeryAichi Cancer Center Hospital Aichi Japan
| | - Yoshitsugu Horio
- Department of Thoracic OncologyAichi Cancer Center Hospital Aichi Japan
| | - Toyoaki Hida
- Department of Thoracic OncologyAichi Cancer Center Hospital Aichi Japan
| | - Kenichi Okubo
- Department of Thoracic SurgeryTokyo Medical and Dental University Tokyo Japan
| | - Yasushi Yatabe
- Department of Pathology and Molecular DiagnosticsAichi Cancer Center Hospital Aichi Japan
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12
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De Luca C, Sgariglia R, Nacchio M, Pisapia P, Migliatico I, Clery E, Gragnano G, Campione S, Vigliar E, Malapelle U, De Dominicis G, Bellevicine C, Troncone G. Rapid On-site Molecular Evaluation in thyroid cytopathology: A same-day cytological and molecular diagnosis. Diagn Cytopathol 2020; 48:300-307. [PMID: 31904908 DOI: 10.1002/dc.24378] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 12/27/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Thyroid fine-needle aspirates (FNAs) with undetermined morphology can be outsourced to centralized laboratories for comprehensive molecular profiling. When a local, rapid screening rules out easily detectable BRAF and NRAS mutations outsourcing is minimized, leading to cost savings. The fully automated Idylla technology, that does not require trained staff, is an emerging option. However, Idylla platform has only been validated to process formalin fixed paraffin embedded (FFPE) sections. Here we investigate whether also the FNA needle rinse could be genotyped by the same cytopathologist who performs the FNA, a procedure that can be termed rapid on site molecular evaluation (ROME). METHODS To validate this approach, the Idylla BRAF and NRAS Test was performed on the rinses from 25 simulated (bench-top) FNAs, in a first part of the study. Genotyping data were compared with those obtained on matched histological FFPE blocks. The second part of the study was carried out on 25 prospectively collected routine FNAs to assess the performance of the Idylla BRAF and NRAS assay against a gold standard real time polymerase chain reaction method. RESULTS Idylla NRAS-BRAF Mutation Test was performed on needle rinse as well as histological FFPE blocks. A sensitivity of 88.9%, a specificity of 100.0% were obtained comparing the Idylla NRAS-BRAF Mutation Test on needle rinse to the reference method. CONCLUSIONS The FNA needle rinse can be directly genotyped. This obviates the need of cell block preparation, making possible a rapid combined morphological and molecular evaluation. Since DNA extraction is no longer necessary, the cytopathologist can perform ROME him/herself.
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Affiliation(s)
- Caterina De Luca
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Roberta Sgariglia
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Mariantonia Nacchio
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Pasquale Pisapia
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Ilaria Migliatico
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Eduardo Clery
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Gianluca Gragnano
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Severo Campione
- Department of Pathology, A.O.R.N. A. Cardarelli, Naples, Italy
| | - Elena Vigliar
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Umberto Malapelle
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | | | - Claudio Bellevicine
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Giancarlo Troncone
- Department of Public Health, University of Naples Federico II, Naples, Italy
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