New type of brochoscopy: ENB

M Levin, MD — Sun, 16 Dec 2012 20:11:12 +0000

ENB (Electromagnetic Navigation Bronchoscopy) or EMN bronchoscopy is a type of bronchoscopy that uses electromagnetic guidance to project catheters into and through bronchial passages. Using a virtual, three-dimensional (3D) bronchial map from a recent CT scan and disposable catheters, it makes it possible toget to preselected spaces and to take biopsies or plan radiation. FDA cleared it in 2004 through the 510(k) process. Studies suggest a higher success rate, but less so for lower lung lobes than the rest of the lung. The British Thoracic Society guidelines for advanced diagnostic and therapeutic flexible bronchoscopy in adults (Du Rand et al, 2011) said that electromagnetic bronchoscopy may be considered for the biopsy of peripheral lesions or to guide trans-bronchial needle aspiration for sampling mediastinal lymph nodes (grade D). Undortunately, one one randomized study had been eprformed and the British Society’s guideline is at a fairly low level of confidence.

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Veristrat: Current Status

M Levin, MD — Fri, 03 Aug 2012 20:39:54 +0000

Veristrat is a new test that was presented in April 2012. at the 3rd European Lung Cancer Conference in Geneva, Switzerland. The Veristrat test was validated through a retrospective analysis was performed on serum samples from advanced non-squamous non-small cell lung cancer (NSCLC) patients treated with the combination therapy of Avastin and plus erlotinib. This means that after the study was finished, the researchers when back and checked tissue samples with Veristrat and then looked to see what happened to patients whose cases they analyzed. Veristrat test was able to identify patients likely to have better and worse survival outcomes in these trials.

A similar analysis of the Phase III trial, EGF30008, was presented at the 2011 CTRC-AACR San Antonio Breast Cancer Symposium. Results showed that the Veristrat test was able to identify a group of patients whose breast cancer came back sooner when treated with Femara alone.

Veristrat test may eventually become accepted to be useful for clinical decision-making, representing about treatment with erlotinib and erlotinib combinations. Prospective trials are ongoing, including a Phase III trial in advanced squamous cell lung cancer, sponsored by the European Thoracic Oncology group. Once these are reported and analyzed, Veristrat may join the current treatment armamentarium but it is still premature to make treatment decisions based on a retrospective analysis. Generally, showing that a test is predictive is not enough. Researchers need to show that selecting treatments based on a test has a beneficial result.

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Cancer Treatment Today » Lung Cancer

New type of brochoscopy: ENB

Veristrat: Current Status