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. 2021 Apr;10(7):2286-2292.
doi: 10.1002/cam4.3769. Epub 2021 Mar 3.

Multigene PCR using both cfDNA and cfRNA in the supernatant of pleural effusion achieves accurate and rapid detection of mutations and fusions of driver genes in patients with advanced NSCLC

Xuejing Chen  1 , Kun Li  1 , Zichen Liu  1 , Fei Gai  2 , Guanshan Zhu  2 , Shun Lu  3 , Nanying Che  1
Affiliations

Multigene PCR using both cfDNA and cfRNA in the supernatant of pleural effusion achieves accurate and rapid detection of mutations and fusions of driver genes in patients with advanced NSCLC

Xuejing Chen et al. Cancer Med. 2021 Apr.

Abstract

Background: Pleural effusion from patients with advanced non-small cell lung cancer (NSCLC) has been proved valuable for molecular analysis, especially when the tissue sample not available. However, simultaneous detection of multiple driver gene alterations especially the fusions is still challenging.

Methods: In this study, 77 patients with advanced NSCLC and pleural effusion were enrolled, 49 of whom had matched tumor tissues. Supernatants, cell sediments, and cell blocks were prepared from pleural effusion samples for detection of driver alterations by a PCR-based 9-gene mutation detection kit.

Results: Mutations in EGFR, KRAS, and HER2 were detected in DNA and cfDNA, fusions in ALK was detected in RNA and cfRNA. Compared with matched tumor tissue, the supernatant showed the highest overall sensitivity (81.3%), with 81.5% for SNV/Indels by cfDNA and 80% for fusions by cfRNA, followed by cell blocks (71.0%) and the cell sediments (66.7%). Within the group of treatment-naïve patients or malignant cells observed in the cell sediments, supernatant showed higher overall sensitivity (89.5% and 92.3%) with both 100% for fusions.

Conclusions: CfDNA and cfRNA derived from pleural effusion supernatant have been successfully tested with a PCR-based multigene detection kit. Pleural effusion supernatant seems a preferred material for detection of multigene alterations to guide treatment decision of advanced NSCLC.

Keywords: ALK fusion; NSCLC; PCR; cfRNA; pleural effusion; supernatant.

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Conflict of interest statement

Guanshan Zhu is the stock holder of Amoy Diagnostics.

Figures

FIGURE 1
FIGURE 1
Flowchart of the analysis for driver gene alterations. cfDNA, cell free DNA; cfRNA, cell free RNA; NSCLC, non‐small cell lung cancer
FIGURE 2
FIGURE 2
The workflow and TAT of different types of pleural effusion sample for driver gene alterations. cfDNA, cell free DNA; cfRNA, cell free RNA; d, days; h, hours; TAT, turnaround time
See this image and copyright information in PMC

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