학술논문
Early Assessment of Chemotherapy Response in Advanced Non-Small Cell Lung Cancer with Circulating Tumor DNA
Document Type
article
Author
Stephanie J. Yaung; Corinna Woestmann; Christine Ju; Xiaoju Max Ma; Sandeep Gattam; Yiyong Zhou; Liu Xi; Subrata Pal; Aarthi Balasubramanyam; Nalin Tikoo; Claus Peter Heussel; Michael Thomas; Mark Kriegsmann; Michael Meister; Marc A. Schneider; Felix J. Herth; Birgit Wehnl; Maximilian Diehn; Ash A. Alizadeh; John F. Palma; Thomas Muley
Source
Cancers, Vol 14, Iss 10, p 2479 (2022)
Subject
Language
English
ISSN
2072-6694
Abstract
Monitoring treatment efficacy early during therapy could enable a change in treatment to improve patient outcomes. We report an early assessment of response to treatment in advanced NSCLC using a plasma-only strategy to measure changes in ctDNA levels after one cycle of chemotherapy. Plasma samples were collected from 92 patients with Stage IIIB-IV NSCLC treated with first-line chemo- or chemoradiation therapies in an observational, prospective study. Retrospective ctDNA analysis was performed using next-generation sequencing with a targeted 198-kb panel designed for lung cancer surveillance and monitoring. We assessed whether changes in ctDNA levels after one or two cycles of treatment were associated with clinical outcomes. Subjects with ≤50% decrease in ctDNA level after one cycle of chemotherapy had a lower 6-month progression-free survival rate (33% vs. 58%, HR 2.3, 95% CI 1.2 to 4.2, log-rank p = 0.009) and a lower 12-month overall survival rate (25% vs. 70%, HR 4.3, 95% CI 2.2 to 9.7, log-rank p < 0.001). Subjects with ≤50% decrease in ctDNA level after two cycles of chemotherapy also had shorter survival. Using non-invasive liquid biopsies to measure early changes in ctDNA levels in response to chemotherapy may help identify non-responders before standard-of-care imaging in advanced NSCLC.