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Oke Gerke



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    EP1.11 - Screening and Early Detection (ID 201)

    • Event: WCLC 2019
    • Type: E-Poster Viewing in the Exhibit Hall
    • Track: Screening and Early Detection
    • Presentations: 1
    • Now Available
    • Moderators:
    • Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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      EP1.11-19 - Surveillance with PET/CT and ctDNA of Lung Cancer Patients After Completion of Definitive Therapy; A Randomized Trial (Now Available) (ID 2678)

      08:00 - 18:00  |  Author(s): Oke Gerke

      • Abstract
      • Slides

      Background

      Even after treatment with curative intent lung cancer patients have a high risk of relapse. Patients are currently followed with CT. However, after surgery and especially radiotherapy CT has limited accuracy potentially delaying the diagnosis of a relapse. There is a scarcity in evidence regarding the most efficient follow-up interval as well as maging method. Together with CT the use of PET/CT for follow-up has been increasing and there is a need for improved understanding and perhaps questioning of the role of imaging in surveillance. Relapse of tumour activity can also be reflected by shedding of tumour DNA (ctDNA) into the blood stream. Studies have shown increase in circulating ctDNA months before standard radiologic assessment. Blood sampling and subsequent analysis of ctDNA therefore represent a promising minimally-invasive strategy to assess genomic tumour material and follow its changes. The purpose of this on-going clinical trial is to improve early detection of lung cancer relapse enabling more patients to receive definitive treatment of their relapse, ultimately leading to improved survival.

      Method

      This national, randomized trial compares two strategies for surveillance of patients with non-small cell lung cancer treated with curative intent (figure 1): standard follow-up +/- imaging with FDG PET/CT. Primary endpoint is frequency of treatable relapse and secondary endpoints includes survival and quality of life, number and type of invasive procedures, adverse events and type of treatment after verification of relapse, as well as use of healthcare resources.Based on samples collected during this randomized trial we will evaluate if monitoring patients with ctDNA enable us to track cancer evolution and detect early signs of relapse, as well as exploring potential new stratification of patient cohort with focus on high-risk and low-risk groups. Hereby, designing an optimal surveillance strategy for individual patients.


      figure1.jpg

      Result

      The trial has been starting gradually since end-2018 and is now including patients in 4/5 Danish regions. The study aims to include 750 patients by 2021. In order to obtain baseline blood sample for ctDNA patients are included both prior to treatment (by April 2019 n=61) and 3 months after treatment (only patients in complete remission, n=25).

      Conclusion

      SUPE_R will provide the scientific basis for implementing new ways for surveillance of patients with lung cancer as well as provide knowledge transferable to other groups of cancer patients. This is the first study considering bioinformatics and methodological aspects of liquid biopsies and relating them directly to imaging and clinical benefits for the patients.

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