'Upcycling pathology': targeted next-generation sequencing is feasible in re-purposed haematoxylin and eosin and immunostained formalin-fixed paraffin-embedded sections in lung cancer biopsies.
Summary
Lung cancer biopsies often yield limited material, complicating predictive molecular testing and sometimes necessitating re-biopsy. This study investigated the feasibility of repurposing routine diagnostic slides, specifically H&E-stained and immunostained sections, for molecular analysis. From 40 lung biopsy specimens, DNA extraction and targeted next-generation sequencing were successfully performed for 33 cases. The results demonstrated high concordance of detected variants, suggesting this approach is a viable alternative for molecular testing.
Analysis
🔴 CLINIQUE: This retrospective feasibility study proposes an innovative solution for lung cancer cases where biopsy material is insufficient for predictive molecular testing. By avoiding re-biopsy, it could reduce diagnostic delays, patient risks, and associated costs, thereby improving patient management. The biomarker here is a predictive marker (molecular variants). If validated on a larger scale, this approach could be integrated into clinical workflows within 3 to 5 years, especially for small biopsies. 🟢 BIOMOL: The key discovery is the technical feasibility of DNA extraction and targeted next-generation sequencing (NGS) from FFPE sections already used for diagnosis (H&E-stained or immunostained). Although DNA quality was suboptimal, the method yielded concordant sequencing results in 82.5% of cases. This approach represents a significant translational advance, allowing for the maximization of precious and limited sample material, and could lead to the development of new clinical testing protocols for lung cancer patients.