Author of

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  P1.01 - Advanced NSCLC (Not CME Accredited Session) (ID 933)

  • Event: WCLC 2018
  • Type: Poster Viewing in the Exhibit Hall
  • Track:
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/24/2018, 16:45 - 18:00, Exhibit Hall

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    P1.01-89 - Analysis and Monitoring CTCs and ctDNA in CSF Demonstrates Clinical Concordance in Tesevatinib Treated NSCLC Patients with LM (ID 11339)

    16:45 - 18:00  |  Author(s): Laurie S. Green
    • Abstract
    • Slides

    Background
    

    Liquid biopsy using blood has emerged as a non-invasive and economical method to assess cancer biomarkers. Applying liquid biopsy methods to evaluate cerebrospinal fluid (CSF) is less well documented and provides key information to supplement routine cytology in patients with brain metastases or leptomeningeal disease (LM). Current first line tyrosine kinase inhibitor (TKI) therapy of (non-small cell lung cancer) NSCLC patients with activating EGFR mutations, exhibits poor penetration to the central nervous system (CNS). About 28% of patients treated with erlotinib or gefitinib progress with CNS involvement. Here we present Biocept’s Target Selector™ technology to evaluate circulating tumor cells (CTCs) and circulating tumor DNA (ctDNA) in the CSF of NSCLC patients with LM, who were treated with tesevatinib in Kadmon’s KD019-206 study.

    a9ded1e5ce5d75814730bb4caaf49419 Method
    

    CSF samples were collected in Biocept CEE-Sure™ blood collection tubes that are validated to preserve CTCs and ctDNA at room temperature for up to 96 hours from collection. The Target Selector™ CTC platform uses an antibody capture cocktail and microfluidic channel for CTC capture and biomarker analysis; the quantitative ctDNA platform incorporates switch-blockers, real time PCR, and sequencing to detect a mutant allele frequency down to 0.05% against wildtype.

    4c3880bb027f159e801041b1021e88e8 Result
    

    CSF collections from 6 NSCLC patients with LM were obtained at baseline, C1D14, and C3D1 of tesevatinib therapy. In all 6 patients, EGFR mutations detected in CSF were concordant to the original tissue mutations. Baseline or emergent T790M ctDNA that was detected in CSF, paralleled progression in 3 patients. CTC enumeration mirrored response to therapy, decrease of symptoms, or progression in 5 of 6 patients; T790M emerged at C1D14 in the patient whose CTCs decreased at progression. Serial CSF CTC and ctDNA analyses were consistent with the overall clinical course of disease.

    8eea62084ca7e541d918e823422bd82e Conclusion
    

    Biocept’s Target Selector™ technology in CSF analysis demonstrated both highly sensitive detection of CTCs and mutant ctDNA in NSCLC patients with LM as well as concordance with tissue and clinical course. Hence, serial monitoring of CSF with CTCs and ctDNA can be utilized to evaluate drug response and disease progression, providing pertinent vital information for disease management and care of LM patients.

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