Residual ctDNA after treatment predicts early relapse in patients with early-stage non-small cell lung cancer.

Abstract:: BACKGROUND: Identification of residual disease in patients with localized non-small cell lung cancer (NSCLC) following treatment with curative intent holds promise to identify patients at risk of relapse. New methods can detect circulating tumour DNA (ctDNA) in plasma to fractional concentrations as low as a few parts per million, and clinical evidence is required to inform their use. PATIENTS AND METHODS: We analyzed 363 serial plasma samples from 88 patients with early-stage NSCLC (48.9%/28.4%/22.7% at stage I/II/III), predominantly adenocarcinomas (62.5%), treated with curative intent by surgery (n = 61), surgery and adjuvant chemotherapy/radiotherapy (n = 8), or chemoradiotherapy (n = 19). Tumour exome sequencing identified somatic mutations and plasma was analyzed using patient-specific RaDaR™ assays with up to 48 amplicons targeting tumour-specific variants unique to each patient. RESULTS: ctDNA was detected before treatment in 24%, 77% and 87% of patients with stage I, II and III disease, respectively, and in 26% of all longitudinal samples. The median tumour fraction detected was 0.042%, with 63% of samples

Authors:: D Gale, K Heider, A Ruiz-Valdepenas, S Hackinger, M Perry, G Marsico, V Rundell, J Wulff, G Sharma, H Knock, J Castedo, W Cooper, H Zhao, CG Smith, S Garg, S Anand, K Howarth, D Gilligan, SV Harden, DM Rassl, RC Rintoul, N Rosenfeld

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