Background and Aims: Introduction of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has allowed for a minimally invasive modality of mediastinal staging and diagnostic tissue sampling for non-small cell lung cancers (NSCLC). With advances in driver mutations and specific targeted molecular therapies, genomic profiling has become a mandatory part of standard diagnostic workup in those with advanced disease, and utility of EBUS-TBNA in this aspect is being furthermore characterised.

Methods and Results: EBUS-TBNA sampling was retrospectively assessed at a tertiary hospital between January 2018 and December 2020 for its yield of several molecular biomarkers by next-generation sequencing (NGS) and immunohistochemistry for those with histopathologically confirmed advanced NSCLC. Preliminary analysis has identified 206 patients diagnosed with NSCLC. 51 patients were evaluated utilising EBUS-TBNA techniques for cytological diagnosis as well as NGS. Of those, 32 patients (62.7%) yielded enough tumour material for successful genotyping of at least one driver mutation. 88% were successfully subtyped on histopathology by EBUS-TBNA sampling.

Conclusion: EBUS-TBNA has been demonstrated as a reliable sampling modality for not only initial cytological diagnosis but concurrent molecular analysis for potential targeted molecular therapies. Further research is required to identify strategies that can maximise the yield of EBUS-TBNA genomic characterisation.