High-Quality Samples for Next-Generation Sequencing and PD-L1 Assessment in Non-Small Cell Lung Cancer: The Role of Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration
<b>Background/Objectives</b>: Recent advances in the treatment of non-small cell lung cancer (NSCLC) have shifted from conventional chemotherapy to targeted therapies aimed at specific genetic mutations, particularly in the adenocarcinoma subtype. These therapies have improved overall su...
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MDPI AG
2025-04-01
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| Online Access: | https://www.mdpi.com/2075-4418/15/9/1064 |
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| author | Marta Rodríguez González Juan Carlos Montero González José María Sayagués Manzano Tamara Clavero Sánchez Jonnathan Roldán Ruiz Miguel Iglesias Heras María Belén Rivas Marcos Mar Abad Hernández Rosa Cordovilla Pérez |
| author_facet | Marta Rodríguez González Juan Carlos Montero González José María Sayagués Manzano Tamara Clavero Sánchez Jonnathan Roldán Ruiz Miguel Iglesias Heras María Belén Rivas Marcos Mar Abad Hernández Rosa Cordovilla Pérez |
| author_sort | Marta Rodríguez González |
| collection | DOAJ |
| description | <b>Background/Objectives</b>: Recent advances in the treatment of non-small cell lung cancer (NSCLC) have shifted from conventional chemotherapy to targeted therapies aimed at specific genetic mutations, particularly in the adenocarcinoma subtype. These therapies have improved overall survival and quality of life. However, some patients still face barriers to accessing these treatments due to challenges in diagnosing advanced-stage NSCLC. Limited tumor cellularity in small biopsies and cytological samples hinders the ability to perform further molecular analyses. Additionally, the increasing number of genetic alterations requiring testing complicates the diagnostic process. To overcome this challenge, we propose combining endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) with next-generation sequencing (NGS) and immunohistochemistry for PD-L1. <b>Methods</b>: A total of 120 EBUS-TBNA samples were consecutively collected during the first year of integrating NGS at a reference hospital in Castilla y León, Spain. Depending on the histology and patient characteristics, a total of 67 NGS analyses and 116 PD-L1 determinations were performed. <b>Results</b>: The cytological sample obtained in these cases successfully achieved the triple objective proposed by the NCCN for lung cancer (diagnosis, staging, and molecular analysis in a single procedure) in 97% of instances. <b>Conclusions</b>: Our study highlights the effectiveness of EBUS-TBNA as a comprehensive, cost-effective, and safe diagnostic tool for NSCLC, successfully achieving the triple objective of diagnosis, staging, and molecular analysis in 97% of cases. The procedure consistently provided high-quality samples for NGS and PD-L1 testing, with minimal complications, reinforcing its value as a reliable approach for optimizing personalized treatment strategies. |
| format | Article |
| id | doaj-art-deee204426114f38920bd56b518ecdfa |
| institution | DOAJ |
| issn | 2075-4418 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj-art-deee204426114f38920bd56b518ecdfa2025-08-20T02:58:47ZengMDPI AGDiagnostics2075-44182025-04-01159106410.3390/diagnostics15091064High-Quality Samples for Next-Generation Sequencing and PD-L1 Assessment in Non-Small Cell Lung Cancer: The Role of Endobronchial Ultrasound-Guided Transbronchial Needle AspirationMarta Rodríguez González0Juan Carlos Montero González1José María Sayagués Manzano2Tamara Clavero Sánchez3Jonnathan Roldán Ruiz4Miguel Iglesias Heras5María Belén Rivas Marcos6Mar Abad Hernández7Rosa Cordovilla Pérez8Department of Pathology, Biomedical Research Institute of Salamanca (IBSAL), University Hospital of Salamanca, 37007 Salamanca, SpainDepartment of Pathology, Biomedical Research Institute of Salamanca (IBSAL), University Hospital of Salamanca, 37007 Salamanca, SpainDepartment of Pathology, Biomedical Research Institute of Salamanca (IBSAL), University Hospital of Salamanca, 37007 Salamanca, SpainDepartment of Pulmonology, University Hospital of Salamanca, 37007 Salamanca, SpainDepartment of Clinical Oncology, University Hospital of Salamanca, 37007 Salamanca, SpainDepartment of Pulmonology, University Hospital of Salamanca, 37007 Salamanca, SpainDepartment of Pathology, Biomedical Research Institute of Salamanca (IBSAL), University Hospital of Salamanca, 37007 Salamanca, SpainDepartment of Pathology, Biomedical Research Institute of Salamanca (IBSAL), University Hospital of Salamanca, 37007 Salamanca, SpainDepartment of Pulmonology, University Hospital of Salamanca, 37007 Salamanca, Spain<b>Background/Objectives</b>: Recent advances in the treatment of non-small cell lung cancer (NSCLC) have shifted from conventional chemotherapy to targeted therapies aimed at specific genetic mutations, particularly in the adenocarcinoma subtype. These therapies have improved overall survival and quality of life. However, some patients still face barriers to accessing these treatments due to challenges in diagnosing advanced-stage NSCLC. Limited tumor cellularity in small biopsies and cytological samples hinders the ability to perform further molecular analyses. Additionally, the increasing number of genetic alterations requiring testing complicates the diagnostic process. To overcome this challenge, we propose combining endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) with next-generation sequencing (NGS) and immunohistochemistry for PD-L1. <b>Methods</b>: A total of 120 EBUS-TBNA samples were consecutively collected during the first year of integrating NGS at a reference hospital in Castilla y León, Spain. Depending on the histology and patient characteristics, a total of 67 NGS analyses and 116 PD-L1 determinations were performed. <b>Results</b>: The cytological sample obtained in these cases successfully achieved the triple objective proposed by the NCCN for lung cancer (diagnosis, staging, and molecular analysis in a single procedure) in 97% of instances. <b>Conclusions</b>: Our study highlights the effectiveness of EBUS-TBNA as a comprehensive, cost-effective, and safe diagnostic tool for NSCLC, successfully achieving the triple objective of diagnosis, staging, and molecular analysis in 97% of cases. The procedure consistently provided high-quality samples for NGS and PD-L1 testing, with minimal complications, reinforcing its value as a reliable approach for optimizing personalized treatment strategies.https://www.mdpi.com/2075-4418/15/9/1064non-small cell lung cancerendobronchial ultrasound-guided transbronchial needle aspirationPD-L1next-generation sequencingcytological samplequality |
| spellingShingle | Marta Rodríguez González Juan Carlos Montero González José María Sayagués Manzano Tamara Clavero Sánchez Jonnathan Roldán Ruiz Miguel Iglesias Heras María Belén Rivas Marcos Mar Abad Hernández Rosa Cordovilla Pérez High-Quality Samples for Next-Generation Sequencing and PD-L1 Assessment in Non-Small Cell Lung Cancer: The Role of Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration Diagnostics non-small cell lung cancer endobronchial ultrasound-guided transbronchial needle aspiration PD-L1 next-generation sequencing cytological sample quality |
| title | High-Quality Samples for Next-Generation Sequencing and PD-L1 Assessment in Non-Small Cell Lung Cancer: The Role of Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration |
| title_full | High-Quality Samples for Next-Generation Sequencing and PD-L1 Assessment in Non-Small Cell Lung Cancer: The Role of Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration |
| title_fullStr | High-Quality Samples for Next-Generation Sequencing and PD-L1 Assessment in Non-Small Cell Lung Cancer: The Role of Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration |
| title_full_unstemmed | High-Quality Samples for Next-Generation Sequencing and PD-L1 Assessment in Non-Small Cell Lung Cancer: The Role of Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration |
| title_short | High-Quality Samples for Next-Generation Sequencing and PD-L1 Assessment in Non-Small Cell Lung Cancer: The Role of Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration |
| title_sort | high quality samples for next generation sequencing and pd l1 assessment in non small cell lung cancer the role of endobronchial ultrasound guided transbronchial needle aspiration |
| topic | non-small cell lung cancer endobronchial ultrasound-guided transbronchial needle aspiration PD-L1 next-generation sequencing cytological sample quality |
| url | https://www.mdpi.com/2075-4418/15/9/1064 |
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