KEBI-Cyto Study - Use of the Biocartis Idylla

Brief summary public domain (ClinicalTrials.gov)

Use of the Biocartis Idylla ™ platform for the detection of Epidermal Growth Factor Receptor, B-RAF and K-RAS proto-oncogene mutations in liquid based cytology specimens and blood plasma samples from patients with non small cell lung carcinoma and pancreatic adenocarcinoma.

Detailed description public domain (ClinicalTrials.gov)

Advances in medicine have resulted in the development of specific drugs to treat cancers that express certain mutations. The detection of epidermal growth factor receptor (EGFR), BRAF and KRAS mutations (10-30%, 1-2%, 25% respectively) in lung cancers and KRAS mutations in 94% of pancreatic cancers allows these patients to be treated with a wider cohort of drugs, potentially resulting in progression free, prolonged survival, with a more favourable tolerability and less adverse effects compared with chemotherapy. NHS England has a test directory which lists the molecular tests that trusts should provide for cancer patients. EGRF, KRAS and BRAF are listed in this directory. Verification of the use of the Idylla would enable this trust to provide all of these molecular tests effectively. Lung and pancreatic cancers both present at advanced disease states and therefore a rapid turnaround of test results is vital. Currently laboratories rely on the use of formalin-fixed paraffin embedded (FFPE) samples for EGFR testing. Clots are produced in the laboratory to congeal all of the tissue fragments and cells into one solid mass. The clotted sample is then fixed in formalin and processed. The current processing and reporting time is 5 days. Liquid based cytology (LBC) specimens obtained through the same sampling procedures are also prepared in the laboratory and fixed using a methanol based fixative called Preservcyt. Previous research has been conducted to determine whether LBC samples can be used instead of FFPE samples for mutation detection with favourable results. A switch to the use of LBC samples for mutation analysis on the Idylla would remove multiple processing steps and make use of residual samples that are currently discarded, which optimises the amount of testing that we can run on small cytology samples, reducing the likelihood of repeat procedures for patients. Alcohol fixation is regarded as a superior method of DNA and RNA preservation, therefore better molecular results will be seen. Detection of circulating tumour cell mutations could in the future negate the need for invasive procedures, with patients requiring a simple blood test for diagnosis. The aim of the study is to determine whether LBC samples are a feasible and reliable alternative to FFPE samples for detecting mutations in LBC samples and blood using the Idylla platform. Hypothesis: EFGR, KRAS and BRAF mutations identified using FFPE samples will be detected in LBC and blood plasma …

Intervention public domain (ClinicalTrials.gov)

Diagnostic_Test: Biocartis Idylla platform - real time PCR detecting EGFR, KRAS and BRAF mutations in liquid based cytology and blood plasma samples. Automated real time PCR mutation analysis - 1. Can the Idylla platform provide a standardised and effective method for detecting EGFR, KRAS and BRAF mutations in blood and liquid based cytology samples for patients with lung and pancreatic cancer. Mutation detection increases the treatment options for patients.

Arm public domain (ClinicalTrials.gov)

EGFR, KRAS, BRAF Lung adenocarcinoma LBC (experimental): Will use residual material from existing LBC cytology samples sent to the laboratory. Routine testing will take priority. Cases identified as non small cell lung carcinoma will have the residual LBC sample tested on the Idylla platform for EGFR, KRAS and BRAF. The EGFR, KRAS and BRAF mutation results obtained using the routine diagnostic procedure (FFPE samples) will be compared to those produced using the LBC samples.

Arm public domain (ClinicalTrials.gov)

KRAS Pancreatic adenocarcinoma (experimental): Will involve testing archived FFPE clot samples from confirmed pancreatic adenocarcinoma patients since 2014 (Approximately 20 cases per year). KRAS testing will be performed using the Idylla platform to establish if there is a KRAS codon 12 mutation present in 94% percent of the cases reported at RCHT. Patients will have consented to the use of their tissue at the time of procedure. Prospectively new patients diagnosed with pancreatic adenocarcinoma will have KRAS testing on the FFPE clot made as part of the routine diagnostic work up and KRAS testing on the LBC sample.

Arm public domain (ClinicalTrials.gov)

EGFR, KRAS, BRAF Blood plasma (experimental): Will involve a blood sample being taken at the time of the procedure from patients that have a clinical suspicion of having lung or pancreatic cancer. The single blood sample will be taken from the cannula inserted for the procedure. The blood sample will be processed using the Biocartis Idylla ™ circulating tumour cell cartridges (EFGR, KRAS and BRAF for lung and KRAS for pancreas).

Primary outcome public domain (ClinicalTrials.gov)

The number of participants with negative and positive mutation status for KRAS, EGFR and BRAF in LBC samples detected using the BioCartis Idylla Platform real time PCR kits.. 1\. Can the Idylla platform provide a standardised and effective method for detecting EGFR, KRAS and BRAF mutations in liquid based cytology samples for patients with lung and pancreatic cancer. Mutation detection increases the treatment options for patients. Time frame: 24 months.

Primary outcome public domain (ClinicalTrials.gov)

The number of patients with a positive KRAS mutation status in Cytolgy clot samples reported as pancreatic adenocarcinoma, using the Biocartis Idylla platform real time PCR kits.. 2\. Establish the mutation prevalence in population served by the Royal Cornwall Hospital. This could provide an avenue for drug development to treat pancreatic cancers Time frame: 24 months.

Primary outcome public domain (ClinicalTrials.gov)

The number of participants with negative and positive mutation status for KRAS, EGFR and BRAF in blood plasma samples detected using the BioCartis Idylla Platform real time PCR kits.. 3\. Testing for mutations in the blood samples and directly comparing it with mutations seen in the cytology samples, will provide valuable information in the reliance of blood tests for cancer diagnosis. Potentially eliminating the need for invasive procedures in the future. Time frame: 24 months.

Eligibility public domain (ClinicalTrials.gov)

Inclusion Criteria: * Cytological / histological diagnosis of non small cell lung carcinoma or pancreatic adenocarcinoma * Patients of any gender ethnicity or socioeconomic grouping * Patients over the age of 18 years Exclusion Criteria: * Other malignancies (Not non small cell lung carcinoma or pancreatic adenocarcinoma) * Benign diagnosis * Patients under the age of 18

Enrollment public domain (ClinicalTrials.gov)

Enrollment: 55 participants (actual).