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Bangalore, India

Veldore V.H.,Health Enterprises | Patil S.,HCG Oncology Hospitals | Prabhudesai S.,Health Enterprises | Satheesh C.T.,HCG Oncology Hospitals | And 10 more authors.
Molecular Diagnosis and Therapy | Year: 2016

Background: Although biopsy is the gold standard for diagnosis, cytological material has often been used to assist in making a pathologic diagnosis as well as for molecular testing in certain cancers such as in the lung, cervix, and head/neck. Objective: Our objective is to share experience from our institution in the use of cytological material in screening for epidermal growth factor receptor (EGFR) mutations in a subset of patients with non-small cell lung cancer (NSCLC). Methods: Fine needle aspirates, pleural effusion, cell blocks of 223 NSCLC patients, where cytology suggested malignancy were screened for EGFR mutation in exons 18–21 using Scorpion® ARMS real-time polymerase chain reaction (PCR) technology. Results: Overall, EGFR mutation was seen in 43.5 % of study samples. Deletions were highest in exon 19 (27.2 %), followed by exon 21 (15.5 %), exon 18 (5.3 %), and exon 20 (1.9 %). Chi-squared analysis revealed a significant correlation for mutation status in women compared with men (χ2 = 5.88, p = 0.02), with exon 19 mutation predominating (χ2 = 5.66, p = 0.02). Conclusion: Our results demonstrate the successful use of cytology material for molecular testing in a subset of NSCLC patients to direct their treatment. © 2015 Springer International Publishing Switzerland Source

Danthala M.,HCG Oncology Hospitals | Kallur K.G.,HCG Oncology Hospitals | Prashant G.R.,HCG Oncology Hospitals | Rajkumar K.,HCG Oncology Hospitals | Raghavendra Rao M.,HCG Oncology Hospitals
European Journal of Nuclear Medicine and Molecular Imaging | Year: 2014

Purpose: The choice of an appropriate treatment option in patients with inoperable or metastatic neuroendocrine tumours (NETs) is limited, and approximately 50 % of patients have advanced NET at diagnosis, and 65 % die within 5 years. Treatment with 177Lu-DOTATATE (177Lu- [DOTA0,Tyr3] octreotate) is a promising new option in the treatment of metastatic NETs. Methods: Patients with metastatic NET who underwent 177Lu-DOTATATE during the period 2009 to 2013 were included in this retrospective study. Follow-up imaging studies including a 68Ga-DOTANOC PET/CT scan and a posttherapy 177Lu-DOTATATE scan were compared with baseline imaging to determine response to treatment. Progression-free survival (PFS) was calculated using the Kaplan-Meier method and Cox regression analysis was also done. Results: Ten patients (25 %) had a minimal response, 13 (32.5 %) had a partial response and 9 (22.5 %) had stable disease. Progressive disease was seen in 8 patients (20 %), including 6 patients who died during or after the treatment period. The estimated mean PFS in those who received one or two cycles of 177Lu-DOTATATE was 8.3 months (95 % CI 6.2 to 10.3 months) compared to an estimated mean PFS of 45.6 months (95 % CI 40.9 to 50.2 months) in those who received more than two cycles of 177Lu-DOTATATE (log-rank Mantel-Cox Χ 2=8.01, p=0.005). Conclusion: Our study showed that treatment with 177Lu- DOTATATE should be considered in the management of NETs, considering the limited success of alternative treatment modalities. Treatment response and PFS is determined primarily by the dose delivered and best results are obtained when more than two cycles of 177Lu-DOTATATE are given, with careful monitoring for possible side effects. © 2014 Springer-Verlag. Source

Veldore V.H.,Reference Pathology Laboratory | Rao R.M.,HCG Oncology Hospitals | Kakara S.,Reference Pathology Laboratory | Pattanayak S.,Reference Pathology Laboratory | And 15 more authors.
Indian Journal of Cancer | Year: 2013

Background: Epidermal growth factor receptor (EGFR) mutation plays a vital role in the prognosis of patients with lung cancer. However, there is a dearth of studies on EGFR mutation in Indian population. In this retrospective study conducted at a network of tertiary cancer care centers across India, we evaluated the proportion of EGFR mutation in patients with non-small-cell lung carcinomas (NSCLC). Materials and Methods: A total of 1036 cases of non-small lung cancer were assessed for EGFR mutation status using Scorpion amplified refractory mutation system real time polymerase chain reaction method from fine needle aspiration cytology core biopsy, pleural fluid and cell blocks. For a few cases, macro dissection of tumor from H and E slides was also performed for EGFR analysis. EGFR Status was assessed for the most commonly known driver mutations in Exons 18, 19, 20 and 21, which contributes to a total of 29 somatic mutations including the resistance mutation T790M. Results: Around 39% of the cohort was female and 61% were male. Mutation was positive in 40.3% and negative (wild type) in 59.7%. There was 1.8% mutation in exon 18, 24.6% in exon 19, 1.6% in exon 20 and 12.8% in exon 21. 38.2% had a mutation in a single site and 1.1% had a mutation in two sites. Overall mutation was significant in females (50.5% vs. 33.9%) compared with males (χ2 = 28.3, P < 0.001). Mutation was significant in exon 21 (16.8% vs. 10.3%, χ2 = 9.44, P = 0.002) and exon 19 (30.7% vs. 20.7%, χ2 = 13.2, P < 0.001) in females compared with males. Conclusion: EGFR is expressed differentially/mutated in patients with NSCLC. Further studies to unravel the predictors for acquired genetic alterations of EGFR are needed. Source

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