We use cookies to understand how you use our site and to improve your experience. This includes personalizing content and advertising. To learn more, click here. By continuing to use our site, you accept our use of cookies. Cookie Policy.

Features Partner Sites Information LinkXpress
Sign In
Advertise with Us
Technopath Clinical Diagnostics

Download Mobile App


ATTENTION: Due to the COVID-19 PANDEMIC, many events are being rescheduled for a later date, converted into virtual venues, or altogether cancelled. Please check with the event organizer or website prior to planning for any forthcoming event.

Lung Cancer Liquid Biopsy Guides MRD-Directed Adjuvant Therapy

By LabMedica International staff writers
Posted on 11 Feb 2020
Print article
Image: Workflow of cancer personalized profiling by deep sequencing (CAPP-Seq) circulating tumor-DNA analysis (ctDNA) (Photo courtesy of Rashedul Islam Rony, PhD).
Image: Workflow of cancer personalized profiling by deep sequencing (CAPP-Seq) circulating tumor-DNA analysis (ctDNA) (Photo courtesy of Rashedul Islam Rony, PhD).
Minimal residual disease (MRD) is the name given to small numbers of leukemic cells (cancer cells from the bone marrow) that remain in the person during treatment or after treatment when the patient is in remission or have no symptoms or signs of disease.

Circulating tumor DNA is tumor-derived fragmented DNA in the bloodstream that is not associated with cells. Circulating tumor DNA (ctDNA) molecular residual disease (MRD) following curative-intent treatment strongly predicts recurrence in multiple tumor types, but whether further treatment can improve outcomes in patients with MRD is unclear.

Oncology specialists at Stanford University (Stanford, CA, USA) and their associates from different institutions applied cancer personalized profiling by deep sequencing (CAPP-Seq) ctDNA analysis to 218 samples from 65 patients receiving chemoradiation therapy for locally advanced non-small-cell lung cancer, including 28 patients receiving consolidation immune checkpoint inhibition (ICI).

The study found that patients with ctDNA evidence of MRD after chemoradiation therapy who then received consolidation ICI had significantly better outcomes than patients with signs of MRD who did not receive consolidation ICI therapy. In contrast patients with undetectable ctDNA after chemoradiation therapy had what the authors called "excellent outcomes" whether or not they received consolidation ICI. Importantly though, one of these patients who showed complete clearance of ctDNA also suffered a significant adverse event, pneumonitis, related to the consolidation ICI. According to authors, the results as a whole provide evidence for the potential utility of using ctDNA tests to define which patients should get immunotherapy treatment, and which might safely avoid it and its potential complications.

Maximillian Diehn, MD, PhD, an associate professor of radiation oncology and a senior author of the study, said, “Our Capp-seq method appears to be very sensitive and to have excellent clinical performance in these locally advanced lung cancer patients, where with a panel design we can find a significant number of mutations in the average patient. However, applying the same method in sarcoma, for example, would likely fail, because these tumors don't show many recurrent mutations.”

The authors concluded that their results suggest that consolidation ICI improves outcomes for non-small-cell lung cancer patients with MRD and that ctDNA analysis may facilitate personalization of consolidation therapy. The study was published on January 20, 2020 in the journal Nature Cancer.

Related Links:
Stanford University

Print article


Molecular Diagnostics

view channel
Image: Photomicrograph of histopathology of Barrett`s esophagus showing the characteristic goblet cells (Alcian blue stain) (Photo courtesy of Nephron).

Genomic Copy Number Predicts Esophageal Cancer Years Before Transformation

Barrett’s esophagus is a condition in which the lining of the esophagus changes, becoming more like the lining of the small intestine rather than the esophagus. This occurs in the area where the esophagus... Read more


view channel
Image: An enzyme-linked immunosorbent assay for mannose-binding lectin found that this molecule is associated with coagulopathy in severe COVID-19 patients (Photo courtesy of Getty Images).

Mannose-Binding Lectin Associated with Coagulopathy in Severe COVID-19

The ongoing COVID-19 pandemic has caused significant morbidity and mortality worldwide, as well as profound effects on society. COVID-19 patients have an increased risk of thromboembolic (TE) complications,... Read more

Industry News

view channel

2020 AACC Annual Scientific Meeting & Clinical Lab Expo to Be an All Virtual Event Due to Coronavirus Pandemic

The American Association for Clinical Chemistry (AACC Washington, DC, USA) has decided to hold the 2020 AACC Annual Scientific Meeting & Clinical Lab Expo as a virtual event, rather than as a live... Read more
Copyright © 2000-2020 Globetech Media. All rights reserved.