Prognostic factors of successful on-purpose tumor biopsies in metastatic cancer patients included in the SHIVA prospective clinical trial

// Emilie Desportes 1 , Mathilde Wagner 1 , Maud Kamal 2 , Anne Vincent Salomon 4 , Gabrielle Deniziaut 4 , Gaelle Pierron 3 , Etienne Rouleau 3 , Thomas Jouffroy 6 , Christophe Le Tourneau 2 , Xavier Paoletti 5 and Vincent Servois 1 1 Departement of Radiology and Nuclear Medecine, Institut Curie, Paris, France 2 Department of Medical Oncology, Institut Curie, Paris, France 3 Department of Genetic, Institut Curie, Paris, France 4 Department of Pathology, Institut Curie, Paris, France 5 Department of Biostatistics and Epidemiology & INSERM U1018 oncostat, Gustave Roussy Cancer Campus, Villejuif, France 6 Department of ENT Surgery, Institut Curie, Paris, France Correspondence to: Vincent Servois, email: // Keywords : cellularity, biopsy, targeted therapies, CT-guided biopsy, precision medicine Received : July 15, 2016 Accepted : September 07, 2016 Published : September 15, 2016 Abstract PURPOSE: To identify patient/tumor characteristics associated with success of biopsy in patients who received multiple lines of chemotherapy. METHODS: Patients with refractory cancer from our center, who were included in a prospective randomized phase II trial comparing targeted therapies based on molecular profile of tumors versus conventional chemotherapy, were retrospectively included in this IRB-approved study. All patients had a biopsy of a tumor lesion performed during surgery, or using CT/palpation/endoscopic guidance. A biopsy was considered successful if the neoplastic cellularity was greater than 30%. Primary lesion, size and location of biopsied lesion, on-going chemotherapy and the differential attenuation between non-enhanced and venous phase (HU) for CT-guided biopsied lesions were recorded. RESULTS: 228 patients (age=59±15yo; M/F=1.9) were included. One hundred and sixty biopsies (72%) of the 221 biopsies performed were successful. Prognostic factors of biopsy success were: no ongoing chemotherapy, surgical or palpation-guided biopsy, lymph nodes/soft tissue location( P <0.01). Among the 221 performed biopsies, 122 (55%) were performed using CT guidance and 82 (67%) were successful. In this subgroup, biopsied 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 was less frequent with CT guidance than with surgical or palpation-guided biopsy and was higher in soft tissues and lymph nodes than that in visceral metastasis. Ongoing chemotherapy decreased tumor cell content and consequently the success of the biopsy samples for molecular profiling.