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Andrea Boscolo Bragadin

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    Lunch & Poster Display session (ID 58)

    • Event: ELCC 2019
    • Type: Poster Display session
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 4/11/2019, 12:30 - 13:00, Hall 1
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      26P - Potentialities of liquid biopsy in advanced non-small cell lung cancer (aNSCLC): Early evaluation of sentinel mutations in plasma and outcome of patients treated with immunotherapy (ID 504)

      12:30 - 13:00  |  Author(s): Andrea Boscolo Bragadin

      • Abstract


      The introduction of immune-checkpoint inhibitors (ICIs) in the management of aNSCLC has led to great outcome improvement, but reliable predictive biomarkers are still a need. Liquid biopsy has the potential to monitor biological effects of treatment. Aim of the study is to explore the potential predictive value of its dynamic analysis in aNSCLC treated with ICIs.

      a9ded1e5ce5d75814730bb4caaf49419 Methods

      aNSCLC patients consecutively treated with ICIs at Istituto Oncologico Veneto were prospectively enrolled and genotyped in tissue. Plasma samples were collected at baseline (T1), after three or four weeks according to the administration schedule (T2) and at the moment of the first radiological evaluation (T3). Patients carrying KRAS mutation in tissue were analyzed in plasma with droplet digital PCR (ddPCR). Semiquantitative index of fractional abundancy of mutated allele (MAFA) was used.

      20c51b5f4e9aeb5334c90ff072e6f928 Results

      aNSCLC patients (N: 54) were prospectively enrolled and tissue genotyped, 24 of them carried KRAS mutation in tissue and 11 (46%) were positive in plasma at baseline. Positivity was not associated with tumor burden or other clinical features. We evaluated the impact of the presence and the quantitative variation of MAFA during treatment on outcome in terms of progression free-survival (PFS). After a median follow-up of 10.9 months, the presence of sentinel mutation at T1 did not affect PFS, whereas the MAFA increase from baseline to T2 and to T3 were associated with shorter PFS (HR: 5.9, 95%CI: 1.2-27.7, p:0.02 and HR: 12.1, 95%CI: 2.3-23.8, p:0.003, respectively). Median PFS was 5.2 months in the presence of MAFA increase T1-2, while it was not reached in case of decreased/stable MAFA.

      fd69c5cf902969e6fb71d043085ddee6 Conclusions

      Increase in MAFA from baseline to three or four weeks after the start of ICI is associated with shorter PFS. Predictive value of dynamic analysis of sentinel mutations in plasma during ICIs treatment warrants further validation in aNSCLC.

      b651e8a99c4375feb982b7c2cad376e9 Legal entity responsible for the study

      Istituto Oncologico Veneto.

      213f68309caaa4ccc14d5f99789640ad Funding

      Istituto Oncologico Veneto.

      682889d0a1d3b50267a69346a750433d Disclosure

      All authors have declared no conflicts of interest.