Circulating Tumor DNA Dynamics Predict Benefit from Consolidation Immunotherapy in Locally Advanced Non-Small Cell Lung Cancer.

Autor: Moding EJ; Department of Radiation Oncology, Stanford University, Stanford, CA, USA.; Stanford Cancer Institute, Stanford University, Stanford, CA, USA., Liu Y; Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA., Nabet BY; Stanford Cancer Institute, Stanford University, Stanford, CA, USA., Chabon JJ; Stanford Cancer Institute, Stanford University, Stanford, CA, USA., Chaudhuri AA; Department of Radiation Oncology, Washington University, St. Louis, MO, USA., Hui AB; Stanford Cancer Institute, Stanford University, Stanford, CA, USA., Bonilla RF; Department of Radiation Oncology, Stanford University, Stanford, CA, USA., Ko RB; Department of Radiation Oncology, Stanford University, Stanford, CA, USA., Yoo CH; Department of Radiation Oncology, Stanford University, Stanford, CA, USA., Gojenola L; Department of Pathology, Stanford University, Stanford, CA, USA., Jones CD; Department of Pathology, Stanford University, Stanford, CA, USA., He J; Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA., Qiao Y; Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA., Xu T; Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA., Heymach JV; Department of Thoracic/Head and Neck Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA., Tsao A; Department of Thoracic/Head and Neck Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA., Liao Z; Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA., Gomez DR; Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA.; Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA., Das M; Division of Oncology, Department of Medicine, Stanford University, Stanford, CA, USA.; Department of Medicine, VA Palo Alto Health Care System, Palo Alto, CA, USA., Padda SK; Division of Oncology, Department of Medicine, Stanford University, Stanford, CA, USA., Ramchandran KJ; Division of Oncology, Department of Medicine, Stanford University, Stanford, CA, USA., Neal JW; Division of Oncology, Department of Medicine, Stanford University, Stanford, CA, USA., Wakelee HA; Division of Oncology, Department of Medicine, Stanford University, Stanford, CA, USA., Loo BW Jr; Department of Radiation Oncology, Stanford University, Stanford, CA, USA., Lin SH; Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA. SHLin@mdanderson.org., Alizadeh AA; Stanford Cancer Institute, Stanford University, Stanford, CA, USA. arasha@stanford.edu.; Division of Oncology, Department of Medicine, Stanford University, Stanford, CA, USA. arasha@stanford.edu.; Institute for Stem Cell Biology and Regenerative Medicine, Stanford University, Stanford, CA, USA. arasha@stanford.edu., Diehn M; Department of Radiation Oncology, Stanford University, Stanford, CA, USA. diehn@stanford.edu.; Stanford Cancer Institute, Stanford University, Stanford, CA, USA. diehn@stanford.edu.; Institute for Stem Cell Biology and Regenerative Medicine, Stanford University, Stanford, CA, USA. diehn@stanford.edu.
Jazyk: angličtina
Zdroj: Nature cancer [Nat Cancer] 2020 Feb; Vol. 1 (2), pp. 176-183. Date of Electronic Publication: 2020 Jan 20.
DOI: 10.1038/s43018-019-0011-0
Abstrakt: 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 remains unclear. We applied CAPP-Seq ctDNA analysis to 218 samples from 65 patients receiving chemoradiation therapy (CRT) for locally advanced NSCLC, including 28 patients receiving consolidation immune checkpoint inhibition (CICI). Patients with undetectable ctDNA after CRT had excellent outcomes whether or not they received CICI. Among such patients, one died from CICI-related pneumonitis, highlighting the potential utility of only treating patients with MRD. In contrast, patients with MRD after CRT who received CICI had significantly better outcomes than patients who did not receive CICI. Furthermore, the ctDNA response pattern early during CICI identified patients responding to consolidation therapy. Our results suggest that CICI improves outcomes for NSCLC patients with MRD and that ctDNA analysis may facilitate personalization of consolidation therapy.
Databáze: MEDLINE
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