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DOI: 10.1055/a-2257-3171
Comparison of endoscopic ultrasound-guided fine-needle aspiration and fine-needle biopsy to generate pancreatic cancer organoids: Randomized trial
Supported by: Deutsche Forschungsgemeinschaft SFB1321 (Project-ID 329628492), RE 3723/4-1Supported by: Deutsche Krebshilfe Max-Eder Program 111273 and 70114328
Clinical Trial: Registration number (trial ID): NCT03990675, Trial registry: ClinicalTrials.gov (http://www.clinicaltrials.gov/), Type of Study: Prospective randomized
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Abstract
Background and study aims The prognosis for pancreatic cancer remains poor. Molecular diagnostics and customized therapies are becoming increasingly important in clinical routine. Patient-derived, predictive model systems such as organoids have the potential to substantially increase the depth of information from biopsy material by functional and molecular characterization. We compared the extent to which the use of fine-needle aspiration needles (FNA, 22G) or fine-needle biopsy needles (FNB, 22G) influences the generation of pancreatic cancer patient-derived organoids (PDOs) to establish endoscopic standards of organoid technology.
Patients and methods Endoscopic ultrasound (EUS)-guided punctures by EUS-FNA and EUS-FNB of pancreatic masses highly suspicious for adenocarcinoma (detected by computed tomography and/or magnetic resonance imaging) were prospectively evaluated. Consecutive patients received EUS-FNA and EUS-FNB in a randomized order without the need to exchange the needle shaft (only the inner needle type (FNA/-B) was exchanged) between the passes. With each needle type, the specimens for histological analysis and for PDOs were obtained separately.
Results Fifty patients were enrolled in the study. Histology revealed malignancy in 42 of 50 cases (84%). In total PDOs were generated from 17 patients (34%). Of these, nine were established by FNB only, two by FNA only, and six by both FNA and FNB. Histology revealed malignancy in 13 of 17 PDO cases (76%). In two histologically false-negative cases, PDOs could be established.
Conclusions EUS-FNB was superior to EUS-FNA in terms of successful generation of PDOs, although it failed to show statistical significance.
Publication History
Received: 18 July 2023
Accepted after revision: 19 December 2023
Article published online:
07 March 2024
© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
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References
- 1 Roser M, Ritchie H. Cancer. Our World Data. https://ourworldindata.org/cancer
- 2 Hidalgo M. Pancreatic cancer. N Engl J Med 2010; 362: 1605-1617 DOI: 10.1056/NEJMoa1304369. (PMID: 24131140)
- 3 Strobel O, Neoptolemos J, Jäger D. et al. Optimizing the outcomes of pancreatic cancer surgery. Nat Rev Clin Oncol 2019; 16: 11-26 DOI: 10.1038/s41571-018-0112-1. (PMID: 30341417)
- 4 Khorana AA, Mangu PB, Berlin J. et al. Potentially curable pancreatic cancer: American Society of Clinical Oncology clinical practice guideline. J Clin Oncol 2016; 34: 2541-2556 DOI: 10.1200/JCO.2016.67.5553. (PMID: 27247221)
- 5 Ma J, Jemal A. The rise and fall of cancer mortality in the USA: why does pancreatic cancer not follow the trend?. Future Oncol 2013; 9: 917-919
- 6 Schmidt KT, Chau CH, Price DK. et al. Precision oncology medicine: The clinical relevance of patient-specific biomarkers used to optimize cancer treatment. J Clin Pharmacol 2016; 56: 1484-1499 DOI: 10.1002/jcph.765. (PMID: 27197880)
- 7 Moreira L, Bakir B, Chatterji P. et al. Pancreas 3D organoids: Current and future aspects as a research platform for personalized medicine in pancreatic cancer. Cell Mol Gastroenterol Hepatol 2018; 5: 289-298 DOI: 10.1016/j.jcmgh.2017.12.004. (PMID: 29541683)
- 8 Dantes Z, Yen HY, Pfarr N. et al. Implementing cell-free DNA of pancreatic cancer patient-derived organoids for personalized oncology. JCI Insight 2020; 5 DOI: 10.1172/jci.insight.137809. (PMID: 32614802)
- 9 Huang L, Holtzinger A, Jagan I. et al. Ductal pancreatic cancer modeling and drug screening using human pluripotent stem cell- and patient-derived tumor organoids. Nat Med 2015; 21: 1364-1371 DOI: 10.1038/nm.3973. (PMID: 26501191)
- 10 Peschke K, Jakubowsky H, Schäfer A. et al. Identification of treatment-induced vulnerabilities in pancreatic cancer patients using functional model systems. EMBO Mol Med 2022; 14: e14876 DOI: 10.15252/emmm.202114876. (PMID: 35119792)
- 11 Tiriac H, Bucobo JC, Tzimas D. et al. Successful creation of pancreatic cancer organoids by means of EUS-guided fine-needle biopsy sampling for personalized cancer treatment. Gastrointest Endosc 2018; 87: 1474-1480 DOI: 10.1016/j.gie.2017.12.032. (PMID: 29325707)
- 12 Kandel P, Tranesh G, Nassar A. et al. EUS-guided fine needle biopsy sampling using a novel fork-tip needle: a case-control study. Gastrointest Endosc 2016; 84: 1034-1039 DOI: 10.1016/j.gie.2016.03.1405. (PMID: 27018087)
- 13 DiMaio CJ, Kolb JM, Benias PC. et al. Initial experience with a novel EUS-guided core biopsy needle (SharkCore): results of a large North American multicenter study. Endosc Int Open 2016; 4: E974-979
- 14 Oppong KW, Bekkali NLH, Leeds JS. et al. Fork-tip needle biopsy versus fine-needle aspiration in endoscopic ultrasound-guided sampling of solid pancreatic masses: a randomized crossover study. Endoscopy 2020; 52: 454-461 DOI: 10.1055/a-1114-5903. (PMID: 32162287)
- 15 Karsenti D, Palazzo L, Perrot B. et al. 22G Acquire vs. 20G Procore needle for endoscopic ultrasound-guided biopsy of pancreatic masses: a randomized study comparing histologic sample quantity and diagnostic accuracy. Endoscopy 2020; 52: 747-753 DOI: 10.1055/a-1160-5485. (PMID: 32408361)
- 16 Tian L, Tang AL, Zhang L. et al. Evaluation of 22G fine-needle aspiration (FNA) versus fine-needle biopsy (FNB) for endoscopic ultrasound-guided sampling of pancreatic lesions: a prospective comparison study. Surg Endosc 2018; 32: 3533-3539 DOI: 10.1007/s00464-018-6075-6. (PMID: 29404729)
- 17 Jones S, Zhang X, Parsons DW. et al. Core signaling pathways in human pancreatic cancers revealed by global genomic analyses. Science 2008; 321: 1801-1806 DOI: 10.1126/science.1164368. (PMID: 18772397)
- 18 Wei S, Lieberman D, Morrissette JJD. et al. Using ‘residual’ FNA rinse and body fluid specimens for next-generation sequencing: An institutional experience. Cancer Cytopathol 2016; 124: 324-329 DOI: 10.1002/cncy.21666. (PMID: 26682952)
- 19 Boj SF, Hwang CI, Baker LA. et al. Organoid models of human and mouse ductal pancreatic cancer. Cell 2015; 160: 324-338 DOI: 10.1016/j.cell.2014.12.021. (PMID: 25557080)
- 20 Juiz N, Elkaoutari A, Bigonnet M. et al. Basal-like and classical cells coexist in pancreatic cancer revealed by single-cell analysis on biopsy-derived pancreatic cancer organoids from the classical subtype. FASEB J Off Publ Fed Am Soc Exp Biol 2020; 34: 12214-12228
- 21 Asokkumar R, Yung Ka C, Loh T. et al. Comparison of tissue and molecular yield between fine-needle biopsy (FNB) and fine-needle aspiration (FNA): a randomized study. Endosc Int Open 2019; 7: E955-E963
- 22 Ishida Y, Tsunoda T, Hamada Y. et al. Standardized methods using EUS-guided fine-needle biopsy and a minimal medium creates three pancreatic cancer organoids. Anticancer Res 2022; 42: 4103-4109 DOI: 10.21873/anticanres.15908. (PMID: 35896269)
- 23 Lacomb JF, Plenker D, Tiriac H. et al. Single-pass vs 2-pass endoscopic ultrasound-guided fine-needle biopsy sample collection for creation of pancreatic adenocarcinoma organoids. Clin Gastroenterol Hepatol 2021; 19: 845-847 DOI: 10.1016/j.cgh.2020.02.045. (PMID: 32119924)