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Nicholas I. Simon
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P1.17 - Treatment of Early Stage/Localized Disease (ID 188)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Treatment of Early Stage/Localized Disease
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2019, 09:45 - 18:00, Exhibit Hall
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P1.17-40 - Clinical Implications of Using Circulating Tumor DNA to Assess Minimal Residual Disease (MRD) in Patients with NSCLC After Definitive Treatment (ID 1801)
09:45 - 18:00 | Presenting Author(s): Nicholas I. Simon
- Abstract
Background
Circulating tumor DNA (ctDNA) has been used to identify driver genomic alterations during treatment of metastatic nonsmall cell lung cancer (NSCLC). Recent studies have also demonstrated the role of ctDNA to monitor response to therapy. Here we performed an analysis on a cohort of NSCLC patients (pts) with localized disease who underwent ctDNA testing after definitive treatments to determine whether ctDNA can be used as a marker of MRD.
Method
Between 2015-2019, 70 pts with localized NSCLC received ctDNA testing. ctDNA testing was done using the next generation sequencing (NGS) panel of 73 genes via digital sequencing technology (Guardant360). Statistical analysis was performed to determine which factors were associated with ctDNA levels and recurrence free survival (RFS).
Result
Of the 70 pts analyzed, 26 pts had ctDNA testing performed after definitive treatment. Median duration of follow up was 22 months (range: 3 to 36). 26% (n = 7) had stage I disease, 30% (n = 8) had stage II disease, and 42% (n = 11) had stage III disease. 81% (n = 21) were adenocarcinoma while 19% (n = 5) were squamous cell carcinoma. 42% (n = 11) had no recurrence during our observation time, while 58% (n = 15) experienced progression. For definitive treatments, 38% (n = 10) underwent surgery alone, 35% (n = 9) underwent surgery with adjuvant chemotherapy, 15% (n = 4) underwent chemoradiation therapy, 8% (n=2) underwent surgery followed by radiation, and 4% (n=1) under went surgery with adjuvant chemoradiation prior to their ctDNA levels [variant allele frequency (VAF)] being drawn. Of these, 15% (n = 4) tested negative for any ctDNA, while 85% (n = 22) were positive. Only one of the pts with undetectable levels of ctDNA experienced recurrence of cancer 34 months after definitive treatment with surgery followed by chemotherapy. 13 among 22 pts with detectable ctDNA had recurrence (median time to recurrence = 6.3 months). Kaplan-Meir survival analysis revealed a trend toward significant association between the presence of detectable ctDNA and RFS (p = 0.10).
Conclusion
Our analysis demonstrates that ctDNA could potentially be used as a marker to assess MRD following definitive treatment for localized NSCLC.
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P2.11 - Screening and Early Detection (ID 178)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Screening and Early Detection
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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P2.11-06 - Serum Proteomic Signature as a Potential Biomarker for Survival in Patients with NSCLC Receiving Immunotherapy (Now Available) (ID 86)
10:15 - 18:15 | Author(s): Nicholas I. Simon
- Abstract
Background
The VeriStrat Test is a serum assay which uses a mass spectrometry (MS)-based proteomic signature derived from machine learning. It is currently used as a prognostic marker for patients with NSCLC receiving chemotherapy. However, little is known about its role for NSCLC patients receiving immune checkpoint inhibitors (ICIs).
Method
This is a retrospective study that includes 47 patients with advanced stage NSCLC without an activating EGFR mutation, who underwent the VeriStrat Test from 2016 to 2018. Spectra from blood samples were evaluated to assign patients into the VeriStrat ‘Good’ (VS-G) or VeriStrat ‘Poor’ (VS-P) risk group. The clinical outcomes of 32 patients who received programmed cell death 1(PD-1) inhibitors nivolumab or pembrolizumab were analyzed by the VeriStrat status.
Result
The VS-G group demonstrated significantly higher progression-free survival (PFS) and overall survival (OS) compared to the VS-P group among overall NSCLC patients regardless of treatment (median PFS of 7.1 vs. 4.2 months, p=0.013, and median OS, not reached vs. 17.2 months, p=0.012). Among NSCLC patients treated with ICIs, VS-G classification was associated with significantly increased PFS in comparison to VS-P classification (median PFS of 6.2 vs. 3.0 months, p=0.012), while the differences in OS trended towards significance (median OS, not reached vs. 16.5 months, p=0.076). Multivariate analyses showed that the VeriStrat status had a borderline significance (p=0.051) in predicting PFS in NSCLC patients treated with ICIs.
Conclusion
MS-based serum proteomic signature has a potential as a biomarker for survival outcome in NSCLC patients receiving immunotherapy.
