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Journal of Biomedical Research | Volume: 29

November 19-20, 2018 | Paris, France

Molecular Biology, Tissue Science and Regenerative Medicine

International Conference on

Joint Event

World Heart Congress

Next generation sequencing: A novel approach to distinguish multifocal primary lung adenocarcinomas

from intrapulmonary metastases

Jean R Lopategui

Cedars-Sinai Medical Center, USA

istinguishing between multiple lung primaries and

intrapulmonary metastases is imperative for accurate

staging. The American Joint Committee on Cancer (AJCC)

criteria are routinely used for this purpose but can yield

equivocal conclusions. We evaluated whether next generation

sequencing using the 50 gene AmpliSeq Cancer Hotspot Panel

v2 can be used to facilitate this distinction. Sequencing was

performed on known primary-metastatic pairs (8 patients)

and multiple lung adenocarcinomas (11 patients). Primary-

metastatic pairs showed high mutational concordance: Seven

pairs shared mutations and 1 was concordant for having no

mutations. Driver mutations in KRAS (4), EGFR (2) and BRAF (1)

were always concordant. Multiple lung tumors from 3 patients

were completely concordant and therefore, were predicted by

sequencing to be intrapulmonary metastases, whereas 8 had

completely discordant mutations and therefore, were predicted

to be primaries. The sequencing prediction correlated with the

AJCC (8th edition) prediction in all patients for whom the latter

was unequivocal (8 of 11). Furthermore, it separated patients by

overall survival: Patients with predicted multiple primaries had

better survival than those with distant metastases (p=0.016,

log-rank test), whereas those with predicted intrapulmonary

metastases showed no difference (p=0.527). With further

validation, the 50 gene panel has the potential to serve as an

adjunct to the AJCC criteria, especially in patients for whom the

latter is equivocal.

Molecular Biology & Heart Congress 2018, Volume 29

DOI: 10.4066/biomedicalresearch-C8-023