Democratizing Next Generation Technology to the Populace: One Community Hospital's Successful Approach to Resolve the Persistent Barrier of Utilizing Core Needles Biopsies for Precision Medicine

Document Type

Conference Proceeding

Publication Date

3-2023

Publication Title

Laboratory Investigation

Abstract

Background: Recently, 70% of oncologists surveyed attributed the inability to treat patients with cutting edge therapies to insufficient access to tissue, and only 18% of pathologist have been able to distribute diagnostic material for further studies when asked. Additionally, 80% of cancer patients receive a portion of their treatment at the community hospital-setting, layering additional barriers to the widespread adoption of advanced testing. Although a variety of factors contribute to this problem, work towards negating these statistics would aid in democratizing the benefits of molecular testing. Previously we tested, in controlled laboratory situations, whether the effluent wash of the biopsy specimen yielded sufficient quantitative and qualitative material for sequencing, as well as to the level of concordance with the parent formalin-fixed tissue. Based on positive results, we extended this approach to the clinical setting, and herein report on our findings of its application. Design: Five core needle biopsies over a 6 month time-frame were collected in the interventional radiology suite immediately upon procurement. Once obtained, the needle was swirled in PBS buffer and transported immediately to the lab. Once received, the tissue core was transferred to a tissue cassette for routine processing. The remaining buffer was spun down and the supernatant discarded. DNA/RNA Shield (Zymo Research) was added, and the contents frozen until all 5 specimens had been collected. DNA was extracted and libraries generated for sequencing. Results: While no cell pellets could be identified in any of the spun down tubes, sufficient amounts of nucleic acids were recovered from the DNA extraction to generate libraries for sequencing on all 5 cases. The quality of the DNA was similar whether it had been frozen for a week or 6 months. Conclusions: This modified processing step results in the recovery of diagnostic material for molecular testing that 1) is simple, and does not require sophisticated equipment; 2) despite outward appearances, reliably recovers enough cellular material for sequencing; 3) does not contribute to tissue exhaustion; and 4) consistently recovers high quality DNA. Adoption of this approach will help in the management of diminutive tissue specimens at any institution where an extensive work-up may be needed, and has the potential to enable greater access of patient’s to molecular testing, foster their enrollment in clinical trials, and provide cost savings by not requiring repeat biopsies.

Volume

103

Issue

3 Suppl

First Page

S1547

Comments

United States and Canadian Academy of Pathology (USCAP) 112th Annual Meeting, March 11-16, 2023, New Orleans, LA 

Last Page

S1548

DOI

10.1016/j.labinv.2023.100098

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