It is typically nondiagnostic to take a bronchoscopy sample of pulmonary lesions that may be lung cancer. It had been demonstrated that an appropriate reclassification of the risk of malignancy (ROM) based on pre-procedure risk might be achieved using a genomic sequencing classifier using bronchial brushings collected at the time of the bronchoscopy. For a study, researchers sought to quantify how frequently the classifier reclassifies risk in routine clinical practice and to simulate the potential therapeutic value of such reclassification.

In the observational investigation, data from four clinical locations were retrospectively evaluated. The sites routinely evaluated indeterminate lesions using the genomic classifier. A record of pre-bronchoscopy ROM and demographic information was kept. It was computed how often classes were upgraded and demoted. To show the possible clinical value of the outcome modeling based on reclassification rates and the classifier’s performance parameters was carried out to show the possible clinical value of the outcome.

Following a nondiagnostic bronchoscopy, 86 individuals who completed classifier testing were included. Prior to bronchoscopy, individuals with high ROM were classed as extremely high-risk in 45% of cases. About 38% of patients with moderate ROM were categorized as higher or lower. Reclassification to extremely low-risk occurred in 56% of individuals with low ROM. In all, 42% of patients had a categorization modification. With subsequent therapy that followed the guidelines, 35% of the research population would have been spared additional needless operations.

Following a nondiagnostic bronchoscopy, the classifier could aid decision-making by reclassifying risk in some instances. The classifier should help more patients with benign diseases avoid additional unnecessary procedures while allowing more patients with early-stage cancer to proceed directly to curative therapy.

Reference: resmedjournal.com/article/S0954-6111(22)00255-4/fulltext