ABSTRACT
Background: The SARS CoV 2 coronavirus pandemic has rocked health care systems to the core. Concurrent circulation of COVID 19 has led to service disruptions and delays in the standard procedures related to lung cancer (LC) diagnose and may negatively impact in the management, care and therapeutic patient intervention. We aimed to determine COVID 19 impact in the molecular diagnosis of LC at our institution. Methods: A total of 203 patients (pts) diagnosed with advanced NSCLC with molecular testing requested in the period of 2019–2020 were included. Clinical characteristics and testing patient results evaluated in 2019 and 2020 were compared. The SOC at our institution includes evaluation of DNA and RNA from tissue(t) and/or blood(b) with NGS or nCounter. Single-gene testing by PCR, IHC and/or FISH is used as complementary assays to NGS when tissue is limited or in case of genomic platform service interruptions. Results: A total of 106 and 97 pts were required for molecular testing during 2019 and 2020 respectively. Clinical patient characteristics in both cohorts were very similar and there were no significant differences in the number of DNA-based or RNA-based analyses required between both period times (DNAt p = 0.25;DNAb p = 0.59;RNAt p =.08). The 2019 cohort identified 66 pts (65%) with driver genes: being KRAS the most commonly detected (34%), followed by EGFR 15%, BRAF 4%, ALK 4% and METΔ14 4%. During 2020, driver alterations were found in 56 pts (60%) in a quite similar proportion except for KRAS mutations, 21%. The total number of non evaluable (NE) samples was significantly increased in 2020 compared to 2019 (p =.029). During 2019, 80% of the NE samples could be evaluated by any multiplex technique. On the contrary, during 2020 only 54% of NE were tested by any NGS-based method. Conclusions: Our results show that molecular diagnosis of LC could be preserved during the COVID 19 outbreak. However genomic service disruptions during critical months of the pandemic clearly impacted in the number of pts with a NE result and might explain the differences in the incidence of KRAS mutations observed. While this global crisis rightly demands the world's attention, a continuous and accurate molecular diagnostic testing must be ensured to guarantee quality-care for LC pts. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: C. Teixido: Honoraria (self), Personal fees: Pfizer;Honoraria (self), Personal fees: Novartis;Honoraria (self), Personal fees: Takeda;Honoraria (self), Personal fees: MSD;Honoraria (self), Personal fees: Roche;Honoraria (self), Personal fees: Diaceutics;Honoraria (self), Personal fees: AstraZeneca;Research grant/Funding (self), Research funding: Pfizer;Research grant/Funding (self), Research funding: Novartis. R. Reyes: Honoraria (self), Speaker Honoraria: Roche;Honoraria (self), Speaker Honoraria: MSD. L. Mezquita: Honoraria (self), Speaker Honoraria: Bristol-Myers Squibb;Honoraria (self), Speaker Honoraria: Tecnofarma;Honoraria (self), Speaker Honoraria: Roche;Honoraria (self), Speaker Honoraria: Takeda;Advisory/Consultancy: Roche Diagnostics;Advisory/Consultancy: Takeda;Advisory/Consultancy: Roche;Travel/Accommodation/Expenses: Bristol-Myers Squibb;Travel/Accommodation/Expenses: Roche;Research grant/Funding (self): Amgen;Research grant/Funding (self): Bristol-Myers Squibb;Research grant/Funding (self): Boehringer Ingelheim;Speaker Bureau/Expert testimony, Mentorship program with key opinion leaders: AstraZeneca. N. Reguart: Honoraria (self), Speaker Honoraria: MSD;Honoraria (self), Speaker Honoraria: BMS;Honoraria (self), Speaker Honoraria: Roche;Honoraria (self), Speaker Honoraria: Boehringer Ingelheim;Honoraria (self), Speaker Honoraria: Guardant Health;Honoraria (self), Speaker Honoraria: Pfizer;Honoraria (self), Speaker Honoraria: AbbVie;Honoraria (self), Speaker Honoraria: Ipsen;Honoraria (self), Speaker Honoraria: Novartis;Honoraria (self), Speaker Honoraria: AstraZeneca;Honoraria (self), Speaker onoraria: Lilly;Honoraria (self), Speaker Honoraria: Takeda;Honoraria (self), Speaker Honoraria: Amgen;Honoraria (self), Organization of educational events: Amgen;Honoraria (self), Organization of educational events: Roche;Advisory/Consultancy: MSD;Advisory/Consultancy: BMS;Advisory/Consultancy: Roche;Advisory/Consultancy: Boehringer Ingelheim;Advisory/Consultancy: Guardant Health;Advisory/Consultancy: Pfizer;Advisory/Consultancy: AbbVie;Advisory/Consultancy: Ipsen;Advisory/Consultancy: Novartis;Advisory/Consultancy: AstraZeneca;Advisory/Consultancy: Lilly;Advisory/Consultancy: Takeda;Advisory/Consultancy: Amgen;Travel/Accommodation/Expenses: Boehringer Ingelheim;Travel/Accommodation/Expenses: MSD;Travel/Accommodation/Expenses: Roche;Research grant/Funding (self): Novartis;Research grant/Funding (self): Pfizer. All other authors have declared no conflicts of interest.