Author of

• 34715

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  P34 - Pathology - Liquid Biopsy (ID 104)

  • Event: WCLC 2020
  • Type: Posters
  • Track: Pathology, Molecular Pathology and Diagnostic Biomarkers
  • Presentations: 1
  • Moderators:
  • Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall

  • 34727

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    P34.08 - Circulating Tumor Cell as a Predictive Marker for Immunotherapy in Advanced Non-Small Cell Lung Cancer (ID 2120)

    00:00 - 00:00  |  Presenting Author(s): Cheol-Kyu Park
    • Abstract
    • Slides

    Introduction
    

    Circulating tumor cells (CTCs) have potential to provide minimally invasive way for the response monitoring of various cancer. This study aimed to investigate the feasibility of CTCs as a predictive marker for anti-PD-1/PD-L1 immunotherapy in patients with advanced non-small cell lung cancer (NSCLC).

    Methods
    

    This study included patients with advanced NSCLC receiving PD-1 or PD-L1 inhibitors as second- or third-line from July 2019 to February 2020. Blood was collected in a K2-EDTA tube before each injection from cycle 1 to 4 (C1 to C4), and CTCs were isolated and enriched by using CD-PRIME^TM system which is antibody-independent size-based isolation method. By Bioview CCBS system, total CTCs (tCTCs) were identified by a sum of single positive cells (sCTC, EpCAM+CK+CD45-) and double positive cells (dCTC, EpCAM+CK+CD45+).

    Results
    

    Among 36 response-evaluable patients, objective response rate and disease control rate were 27.8% (10/36) and 63.9% (23/36), respectively. Baseline CTC counts were not significantly different according to best response. The sCTC count difference from C1 to last cycle showed a correlation with the percentage of RECIST (Spearman`s rho, r_s=0.567, p=0.007). Patients with partial response showed lower sCTC count at C3 (median, 2.3 vs. 6.4, p=0.078) and C4 (1.6 vs. 4.9, p=0.087) than those with progressive disease (PD). The subgroup with high sCTC increase from C1 to C3 (cutoff: 87.5%) showed higher PD rate than the subgroup with low sCTC increase or decrease (60.0% vs. 7.7%, p=0.044). The subgroup with high dCTC increase from C1 to C2 (cutoff: 200%) showed higher PD rate than the subgroup with low dCTC increase or decrease (75.0% vs. 16.7%, p=0.008). Patients with high increase of sCTC (C1 to C3) and dCTC (C1 to C2) showed worse median progression-free survival than those with low increase or decrease of sCTC (2.1 vs. not reached, p=0.078) and dCTC (1.9 vs. not reached, p=0.002).

    Conclusion
    

    The sCTC count during treatment and high increase of sCTC and dCTC from baseline could be potential biomarkers to predict the disease progression and poor survival in patients with advanced NSCLC who received anti-PD-1/PD-L1 immunotherapy.

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