PDF(Pubmed)
Abstract：
Liquid biopsy is rapidly becoming an indispensable tool in the oncologist\'s arsenal; however, this technique remains elusive in a publicly funded healthcare system, and real-world evidence is needed to demonstrate utility and feasibility. Here, we describe the first experience of an in-house point of care liquid biopsy program at a Canadian community hospital. A retrospective review of consecutive cases that underwent plasma-based next-generation sequencing (NGS) was conducted. Liquid biopsy was initiated at the discretion of clinicians. Sequencing followed a point of care workflow using the Genexus™ integrated sequencer and the Oncomine precision assay, performed by histotechnologists. Results were reported by the attending pathologist. Eligible charts were reviewed for outcomes of interest, including the intent of the liquid biopsy, results of the liquid biopsy, and turnaround time from blood draw to results available. A total of 124 cases, with confirmed or suspected cancer, underwent liquid biopsy between January 2021 and November 2023. The median turnaround time for liquid biopsy results was 3 business days (range 1-12 days). The sensitivity of liquid biopsies was 71%, compared to tissue testing in cases with matched tissue results available for comparison. Common mutations included EGFR (29%), in 86 lung cancer patients, and PIK3CA (22%), identified in 13 breast cancer patients. Healthcare providers ordered liquid biopsies to inform diagnostic investigations and treatment decisions, and to determine progression or resistance mechanisms, as these reasons often overlapped. This study demonstrates that rapid in-house liquid biopsy using point of care methodology is feasible. The technique facilitates precision treatment and offers many additional advantages for cancer care.
摘要：
液体活检正在迅速成为肿瘤学家的武器库中不可或缺的工具；然而，这项技术在公共资助的医疗保健系统中仍然难以捉摸，和现实世界的证据是需要证明的效用和可行性。这里,我们描述了在加拿大社区医院进行内部护理点液体活检计划的首次经验.对接受基于血浆的下一代测序（NGS）的连续病例进行了回顾性审查。液体活检由临床医生自行决定。测序遵循使用Genexus™集成测序仪和Oncomine精密测定的护理工作流程点,由组织技术专家执行。结果由主治病理学家报告。对符合条件的图表进行了审查，以了解感兴趣的结果，包括液体活检的意图，液体活检的结果，以及从抽血到可用结果的周转时间。共124例,确诊或疑似癌症，2021年1月至2023年11月期间接受了液体活检.液体活检结果的中位周转时间为3个工作日（范围1-12天）。液体活检的敏感性为71％，与具有匹配组织结果的情况下的组织测试进行比较。常见突变包括EGFR（29%），在86名肺癌患者中，和PIK3CA（22％），在13名乳腺癌患者中发现。医疗保健提供者下令进行液体活检，以告知诊断调查和治疗决定，并确定进展或耐药机制，因为这些原因经常重叠。这项研究表明，使用护理方法进行快速内部液体活检是可行的。该技术有助于精确治疗，并为癌症护理提供了许多额外的优势。
