Author of

• 25941

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  P2.04 - Immunooncology (Not CME Accredited Session) (ID 953)

  • Event: WCLC 2018
  • Type: Poster Viewing in the Exhibit Hall
  • Track:
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/25/2018, 16:45 - 18:00, Exhibit Hall

  • 26977

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    P2.04-02 - Predictive Value of Circulating Tumor Cells and Circulating Free DNA in NSCLC Patients Treated with Nivolumab (ID 13809)

    16:45 - 18:00  |  Author(s): Vincenzo Fontana
    • Abstract

    Background
    

    Immunotherapy represents a dramatic change in the treatment of non small cell lung cancer (NSCLC), but nowadays prognostic and predictive factors of response to immune checkpoint inhibitors (ICIs) are still under debate. It has been observed that circulating biomarkers might have a prognostic role in lung cancer. The aim of this study was to determine whether circulating tumor cells (CTCs) as well as circulating free DNA (cfDNA) might predict the outcome of patients with advanced NSCLC treated with Nivolumab.

    a9ded1e5ce5d75814730bb4caaf49419 Method
    

    From May 2015 to April 2017 89 NSCLC patients were treated with Nivolumab as a second or further line of therapy. All patients underwent blood sample collection before the start of treatment (baseline) and after 4 and 7 cycles of Nivolumab to evaluate both biomarkers. CTCs were isolated from 3mL of blood by the filtration-based device ScreenCell Cyto (ScreenCell) according to manufacturer’s protocol. cfDNA was extracted from plasma using the QIAamp DNA Blood Mini Kit (Qiagen) and quantified (ng/mL) by qPCR method, using hTERT single copy gene. The median baseline CTC number and cfDNA content were used as cut-off values to discriminate patients with different outcomes. An univariate analysis was done to evaluate the overall survival (OS) in the study population based on CTC and cfDNA using the Kaplan Meyer method.

    4c3880bb027f159e801041b1021e88e8 Result
    

    The median CTC number and cfDNA at baseline were 2/3mL and 836.5 ng/mL, respectively. Median OS was 8.8 and 6.2 months for patients with baseline CTC ≤2 and >2, respectively (HR 1.53, 95% CI 0.96-2.42; p=0.072). Similarly, patients with high level of cfDNA > 836.5 ng/ml showed a worse OS as compared with those having lower cfDNA: 5.1 vs 9.4 months (HR 1.63, 95% CI 1.02-2-59; p=0.040).

    8eea62084ca7e541d918e823422bd82e Conclusion
    

    A statistically significant advantage in terms of OS was observed in the group of patients with baseline cfDNA below the median value. Similarly, a longer survival, although of borderline significance, was observed in the group of patients with baseline CTC ≤2. Longitudinal change evaluations of both circulating biomarkers compared to radiological tumor size are currently ongoing.

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