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

• DOI: 10.3390/diagnostics15091064
• Publication Date: 2025-04-23T00:11:48Z
• Authors: Marta Rodríguez G...; Juan Carlos Monte...; José María Sayagu...; Tamara Clavero Sá...; Jonnathan Roldán ...; Miguel Iglesias H...; María Belén Rivas...; Mar Abad Hernández; Rosa Cordovilla P...
• Keywords: Lung cancer staging

Background/Objectives: 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 adenocarcinoma subtype. These improved overall survival and quality life. However, some patients still face barriers accessing these treatments due challenges diagnosing advanced-stage NSCLC. Limited tumor cellularity small biopsies cytological samples hinders ability perform further molecular analyses. Additionally, increasing number alterations requiring testing complicates diagnostic process. To overcome this challenge, we propose combining endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) with next-generation sequencing (NGS) immunohistochemistry for PD-L1. Methods: A total 120 EBUS-TBNA were consecutively collected during first year integrating NGS a reference hospital Castilla y León, Spain. Depending on histology patient characteristics, 67 analyses 116 PD-L1 determinations performed. Results: The sample obtained cases successfully achieved triple objective proposed by NCCN (diagnosis, staging, analysis single procedure) 97% instances. Conclusions: Our study highlights effectiveness as comprehensive, cost-effective, safe tool NSCLC, achieving diagnosis, cases. procedure consistently provided high-quality testing, minimal complications, reinforcing its value reliable approach optimizing personalized strategies.