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H. Brunnström

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    Poster Display session (Friday) (ID 65)

    • Event: ELCC 2018
    • Type: Poster Display session
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 4/13/2018, 12:30 - 13:00, Hall 1
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      94P - Lung cancer recurrence in patients with pre-operative circulating tumor DNA and elevated tumor markers (ID 449)

      12:30 - 13:00  |  Author(s): H. Brunnström

      • Abstract
      • Slides

      Recurrence after surgically treated non-small cell lung cancer (NSCLC) is frequent. A subset of NSCLCs harbors mutations that are routinely analyzed in tumor tissue but can also be detected in cell-free circulating tumor DNA (ctDNA). We performed mutation analysis of tumors to subsequently quantify corresponding mutated ctDNA in pre-operative plasma. Furthermore, we analyzed five tumor markers in pre-operative serum to study the potential of these blood-based methods to predict lung cancer recurrence.

      Plasma and serum were collected pre-operatively from 167 patients surgically treated for primary lung adenocarcinoma at the Lund University Hospital 2005–2014. Tumor specimens were analyzed with Next-Generation Sequencing (NGS). 76/167 tumors harbored at least one mutation in either of the EGFR, BRAF or KRAS genes. Cell-free DNA from corresponding plasma (0.6 to 1.4 mL) was analyzed for mutations in these three genes using the IBSAFE method, an innovation upon standard droplet digital PCR. The tumor markers carcinoembryonic antigen, neuron-specific enolase, cancer antigen 125, human epididymis protein 4 and carbohydrate antigen 19–9 were analyzed in serum with electrochemiluminiscence immunoassay.

      So far ctDNA and tumor markers have been analyzed in 41 cases. Twenty-nine patients had ≥1 elevated tumor markers and 10 had detectable ctDNA. Information about recurrence was missing in two patients. Sixteen patients were diagnosed with recurrence. Of these, nine had ≥1 elevated tumor markers, three had detectable ctDNA and two had both ctDNA and ≥1 tumor markers. Of 16 patients without recurrence, 10 had at ≥1 elevated tumor marker, one had detectable ctDNA, and one patient had positive ctDNA in combination with one elevated tumor marker. Four patients had stage IV disease at time of diagnosis, two of them with ctDNA and all four with ≥1 tumor markers.

      In summary, ctDNA and/or tumor markers might be useful to identify NSCLC patients with increased risk of recurrence but it remains to be investigated in larger studies and with greater plasma volumes how these biomarkers may fit into lung cancer management.

      Clinical trial identification:

      Legal entity responsible for the study:
      Lund University

      The Swedish Cancer Society, Skane University Hospital Foundation, the Mrs Berta Kamprad Foundation, the Gustav V:s Jubilee Foundation, the Gunnar Nilsson Cancer Foundation, BioCARE a Strategic Research Program at Lund University, and governmental funding (ALF)

      A.M. George, L.H. Saal: Named inventor of related intellectual property and shareholder of SAGA Diagnostics. All other authors have declared no conflicts of interest.

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