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Updated: Jan 11, 2026

Author Spotlight: Advancements in Molecular Biomarker Testing for Non-Squamous Non-Small Cell Lung Cancer
Published on: September 8, 2023
Feasibility of next-generation sequencing using bronchoscopic specimens in potentially resectable non-small cell lung
Kaito Yano1,2, Yuji Matsumoto1,3, Hideaki Furuse1
1Department of Endoscopy, Respiratory Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan.
Background:
With advances in multimodal treatment, the importance of identifying biomarkers by bronchoscopy has increased, even in potentially resectable non-small cell lung cancer (NSCLC). However, it remains unclear whether next-generation sequencing (NGS) using bronchoscopic specimens is as useful in potentially resectable NSCLC as in unresectable cases. The objective of this study was to evaluate the feasibility of performing NGS using bronchoscopic specimens obtained from patients with potentially resectable NSCLC.
Methods:
The patients diagnosed with NSCLC via bronchoscopy at National Cancer Center Hospital who underwent NGS were retrospectively analyzed. We allocated all N0-2 and M0 and N3 and/or M1 cases to the potentially resectable and unresectable groups, respectively. Patients were divided into three subgroups according to the target: endobronchial, peri-tracheal/bronchial, and lung lesions. The NGS analytical success rates for potentially resectable NSCLC were compared with unresectable cases for each subgroup to investigate the feasibility of NGS-targeted bronchoscopy.
Results:
Among the 644 patients, 184 had potentially resectable disease, and 460 had unresectable disease. The overall NGS analytical success rate was significantly lower in the potentially resectable group than in unresectable group (81.0% vs. 87.8%, P=0.03). Concerning endobronchial and peri-tracheal/bronchial lesions, there were no significant differences in the NGS analytical success rates (85.7% vs. 100%, P=0.48; and 84.9% vs. 88.2%, P=0.44). The NGS analytical success rate for lung lesions was significantly lower in the potentially resectable group (73.4% vs. 86.4%, P=0.03). Inner-located tumors (P=0.04) were significant factors associated with analytical success.
Conclusions:
The overall rate of successful NGS analysis using bronchoscopic specimens were lower in potentially resectable NSCLC cases, especially in lung lesions. To improve NGS feasibility, it is important to adequately harvest lung lesions and prioritize targeting endobronchial or peri-tracheal/bronchial lesions.

