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Master Thesis

Évaluation des facteurs pronostiques de réussite de biopsie avant thérapie ciblée pour cancer métastatique en progression sous chimiothérapie

Abstract : Purpose : to identify patient/tumor characteristics associated with success of biopsy in patients who received multiple lines of chemotherapy with refractory cancer. Material and methods : all patients with refractory cancer who were included in our center in a prospective randomized phase II trial comparing targeted therapies based on molecular profile of tumors versus conventional chemotherapy, were retrospectively included in this study. A biopsy of a tumor lesion was mandatory, performed during surgery or using CT/palpation/endoscopic guidance and was considered successful if neoplastic cellularity was ≥30%. Primary lesion, size, location of the biopsied lesion and ongoing chemotherapy were recorded, as well as the differential attenuation between non-enhanced and venous phase on CT. Results : 221 patients (age=59±14yo) were included. Prognostic factors of biopsy success were: no ongoing chemotherapy, surgical/palpation-guided biopsy, and lymph nodes/soft tissue location(P<0.01). Among the 221 performed biopsies, 122(55%) were performed using CT guidance and 160(72%) were successful. In CTguided biopsies, lesions located in lymph nodes/soft tissue were associated with a higher success rate, while lung location was associated with failure (P<0.01). The mean differential attenuation was significantly higher in lesions with a successful biopsy (P<0.001). Conclusion : success of biopsy for molecular profiling was less frequent with CT-guidance than with surgical/palpation-guided biopsy. Tumor cell content seemed to be decreased by ongoing chemotherapy and was higher in soft tissues and lymph nodes in visceral metastasis
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https://dumas.ccsd.cnrs.fr/dumas-01600517
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Emilie Desportes. Évaluation des facteurs pronostiques de réussite de biopsie avant thérapie ciblée pour cancer métastatique en progression sous chimiothérapie. Sciences du Vivant [q-bio]. 2016. ⟨dumas-01600517⟩

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