UNASSIGNED: 7518 Background: Cancer diagnostic and treatment strategies are shifting from organ-of-origin and histology-based paradigms to genotype-based approaches, especially in @entity1149 . Responding to the clinical need for real-time, effective @entity5 genotyping, we implemented SNaPshot (SS), a clinical genotyping panel that uses formalin-fixed paraffin-embedded tissue. METHODS: This was a retrospective chart review of all @entity1149 @entity1 (pts) undergoing SS genotyping at Massachusetts General Hospital Cancer Center from March 2009 to May 2010. @entity5 were tested for common hot-spot mutations or translocations in 14 @entity5 -related genes including @entity470 , @entity984 , @entity7041 , @entity817 , @entity10160 , @entity8497 , @entity876 , @entity3546 and others. RESULTS: During the study period, 552 of 589 samples (94%) sent for SS were successfully genotyped. Pt median age was 62, with 58% female and 92% white. 81% of cases were @entity420 ; smoking status was 24% never, 51% former and 11% current; and 64% had stage III or IV disease. Median turn around time for SS results was 20 days. 48% of samples were positive for a mutation or translocation, including 25% @entity984 , 13% @entity470 , 5% @entity7382 % @entity876 , 4% @entity10160 , 2% @entity817 % @entity8497 , and 1 pt each with @entity1722 and @entity818 . @entity3546 tended to co-exist with other mutations, including @entity470 and @entity10160 . @entity470 , @entity7041 and @entity817 mutations were associated with low smoking; @entity984 and @entity8497 with heavy smoking. @entity470 and @entity984 were more common in @entity420 ; @entity10160 was associated with squamous cell histology. @entity7041 was associated with younger age and @entity984 with earlier stage. Overall, 15% of pts with advanced or recurrent @entity1149 during the trial period enrolled on a clinical study of a targeted agent as a result of their genotype and an additional 4% went on an @entity470 TKI off-protocol due to SS results. @entity5 staging dilemmas were clarified via SS analysis of multiple biopsies in 6 cases. CONCLUSIONS: Broad @entity5 genotyping is increasingly important in @entity1149 . In our cohort, about half of pts had an identifiable mutation or translocation. We demonstrated that SS testing is feasible in a clinical setting, and can influence treatment options.

SNaPshot genotyping of @entity1149 ( XXXX ) in clinical practice.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity7041 :: ('238', 'Gene') :: ['ALK'] @entity7382 :: ('7046', 'Gene') :: ['ALK, 5'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor', 'Tumors', 'cancer', 'Tumor'] @entity984 :: ('3845', 'Gene') :: ['KRAS'] @entity470 :: ('1956', 'Gene') :: ['EGFR'] @entity1149 :: ('MESH:D002289', 'Disease') :: ['NSCLC'] @entity420 :: ('MESH:D000230', 'Disease') :: ['adenocarcinoma'] @entity876 :: ('7157', 'Gene') :: ['TP53'] @entity3546 :: ('1499', 'Gene') :: ['Beta-catenin', 'beta-catenin'] @entity818 :: ('3417', 'Gene') :: ['IDH1'] @entity8497 :: ('4893', 'Gene') :: ['NRAS'] @entity817 :: ('673', 'Gene') :: ['beta-catenin, 1% BRAF, 1', 'BRAF'] @entity10160 :: ('5290', 'Gene') :: ['PIK3CA'] @entity1722 :: ('2064', 'Gene') :: ['HER2']
@entity1149 :: (MESH:D002289,Disease) :: ['NSCLC']
