2. Academic Validation
  3. The important role of routine cytopathology in pediatric precision oncology

The important role of routine cytopathology in pediatric precision oncology

  • Cancer Cytopathol. 2021 Oct;129(10):805-818. doi: 10.1002/cncy.22448.
Jinhan Xie 1 2,  Amit Kumar 1 3,  M Emmy M Dolman 1,  Chelsea Mayoh 1 2,  Dong-Anh Khuong-Quang 4,  Roxanne Cadiz 1,  Marie Wong-Erasmus 1,  Emily V A Mould 1,  Dylan Grebert-Wade 1,  Paulette Barahona 1,  Alvin Kamili 1 2,  Maria Tsoli 1,  Timothy W Failes 1 5,  Shu-Oi Chow 1 5,  Greg M Arndt 1 5,  Kanika Bhatia 4,  Glenn M Marshall 1 6,  David S Ziegler 1 2 6,  Michelle Haber 1 2,  Richard B Lock 1 2,  Vanessa Tyrrell 1,  Loretta Lau 1 7,  Penny Athanasatos 8,  Andrew J Gifford 1 2 8
Affiliations

Affiliations

  • 1 Children's Cancer Institute, Lowy Cancer Research Centre, University of New South Wales (UNSW) Sydney, Randwick, New South Wales, Australia.
  • 2 School of Women's and Children's Health, UNSW Sydney, Randwick, New South Wales, Australia.
  • 3 Peter MacCallum Cancer Center, Melbourne, Victoria, Australia.
  • 4 Children's Cancer Center, Murdoch Children's Research Institute, The Royal Children's Hospital, Melbourne, Victoria, Australia.
  • 5 Australian Cancer Research Foundation Drug Discovery Center, Children's Cancer Institute, Lowy Cancer Research Centre, UNSW Sydney, Randwick, New South Wales, Australia.
  • 6 Kids Cancer Center, Sydney Children's Hospital, Randwick, New South Wales, Australia.
  • 7 Children's Cancer Center, Royal Children's Hospital, Parkville, Victoria, Australia.
  • 8 Department of Anatomical Pathology, Prince of Wales Hospital, Randwick, New South Wales, Australia.
PMID: 34043284 DOI: 10.1002/cncy.22448
Abstract

Background: The development of high-throughput drug screening (HTS) using primary cultures provides a promising, clinically translatable approach to tailoring treatment strategies for patients with Cancer. However, this has been challenging for solid tumors because of often limited amounts of tissue available. In most cases, in vitro expansion is required before HTS, which may lead to overgrowth and contamination by non-neoplastic cells.

Methods: In this study, hematoxylin and eosin staining and immunohistochemical staining were performed on 129 cytopathology cases from 95 patients. These cytopathology cases comprised cell block preparations derived from primary tumor specimens or patient-derived xenografts as part of a pediatric precision oncology trial. Cytopathology cases were compared with the morphology and immunohistochemical staining profile of the original tumor. Cases were reported as tumor cells present, equivocal, or tumor cells absent. The HTS results from cytopathologically validated cultures were incorporated into a multidisciplinary tumor board report issued to the treating clinician to guide clinical decision making.

Results: On cytopathologic examination, tumor cells were present in 77 of 129 cases (60%) and were absent in 38 of 129 cases (29%), whereas 14 of 129 cases (11%) were equivocal. Cultures that contained tumor cells resembled the tumors from which they were derived.

Conclusions: Cytopathologic examination of tumor cell block preparations is feasible and provides detailed morphologic characterization. Cytopathologic examination is essential for ensuring that samples submitted for HTS contain representative tumor cells and that in vitro drug sensitivity data are clinically translatable.

Keywords

cytopathology; pediatrics; precision oncology; primary cell culture; validation study.

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