OBJECTIVES: Liquid biopsy and comprehensive genomic profiling (CGP) of circulating tumor DNA (ctDNA) are increasingly used for detection of targetable genomic alterations (GA) in non-small cell lung cancer (NSCLC). To examine the clinical outcomes for patients following CGP using liquid biopsy versus tissue biopsy, receipt of matched targeted therapy post-CGP and associated outcomes were evaluated in the real-world setting. METHODS: 6491 patients with NSCLC and liquid biopsy (N = 937 tests) and/or tissue (N = 5582 tests) CGP were included in a de-identified commercial clinico-genomic database. Targetable GAs included National Comprehensive Cancer Network NSCLC guideline biomarkers. Clinical characteristics, real-world progression, and real-world response (rwR) were obtained via technology-enabled abstraction of clinician notes and radiology/pathology reports. RESULTS: At the time of liquid biopsy CGP, 53% (496/937) of patients were documented to have received ≥1 line of prior therapy (tissue CGP: 13%, 735/5582). 90% (832/928) of liquid biopsy cases had evidence of ctDNA. A targetable GA was detected in 20% (188/937) of liquid biopsy and 22% (1215/5582) of tissue CGP cases. Use of matched targeted therapy overall was similar post-liquid biopsy or post-tissue CGP but varied considerably across emerging (25%, 79/317) versus standard of care (SOC) (74%, 475/640) GA. Real-world-progression free survival for patients receiving SOC first line matched targeted therapy administered following liquid biopsy (n = 33) and tissue (n = 229) CGP were similar (13.8 vs 10.6 months; aHR = 0.68 [0.36-1.26]). Among patients evaluated for rwR, overall response rate (partial/complete response) to matched targeted therapy post-liquid biopsy CGP was 75% (39/52) versus 66% post-tissue CGP (254/385, P = 0.51). CONCLUSION: Retrospective analysis of real-world clinico-genomic data demonstrated that clinical outcomes on matched targeted therapy were similar following liquid biopsy and tissue CGP in NSCLC, which suggests routine clinical use of liquid biopsy CGP can reliably guide therapy selection.
OBJECTIVES: Liquid biopsy and comprehensive genomic profiling (CGP) of circulating tumor DNA (ctDNA) are increasingly used for detection of targetable genomic alterations (GA) in non-small cell lung cancer (NSCLC). To examine the clinical outcomes for patients following CGP using liquid biopsy versus tissue biopsy, receipt of matched targeted therapy post-CGP and associated outcomes were evaluated in the real-world setting. METHODS: 6491 patients with NSCLC and liquid biopsy (N = 937 tests) and/or tissue (N = 5582 tests) CGP were included in a de-identified commercial clinico-genomic database. Targetable GAs included National Comprehensive Cancer Network NSCLC guideline biomarkers. Clinical characteristics, real-world progression, and real-world response (rwR) were obtained via technology-enabled abstraction of clinician notes and radiology/pathology reports. RESULTS: At the time of liquid biopsy CGP, 53% (496/937) of patients were documented to have received ≥1 line of prior therapy (tissue CGP: 13%, 735/5582). 90% (832/928) of liquid biopsy cases had evidence of ctDNA. A targetable GA was detected in 20% (188/937) of liquid biopsy and 22% (1215/5582) of tissue CGP cases. Use of matched targeted therapy overall was similar post-liquid biopsy or post-tissue CGP but varied considerably across emerging (25%, 79/317) versus standard of care (SOC) (74%, 475/640) GA. Real-world-progression free survival for patients receiving SOC first line matched targeted therapy administered following liquid biopsy (n = 33) and tissue (n = 229) CGP were similar (13.8 vs 10.6 months; aHR = 0.68 [0.36-1.26]). Among patients evaluated for rwR, overall response rate (partial/complete response) to matched targeted therapy post-liquid biopsy CGP was 75% (39/52) versus 66% post-tissue CGP (254/385, P = 0.51). CONCLUSION: Retrospective analysis of real-world clinico-genomic data demonstrated that clinical outcomes on matched targeted therapy were similar following liquid biopsy and tissue CGP in NSCLC, which suggests routine clinical use of liquid biopsy CGP can reliably guide therapy selection.
Authors: Coren A Milbury; James Creeden; Wai-Ki Yip; David L Smith; Varun Pattani; Kristi Maxwell; Bethany Sawchyn; Ole Gjoerup; Wei Meng; Joel Skoletsky; Alvin D Concepcion; Yanhua Tang; Xiaobo Bai; Ninad Dewal; Pei Ma; Shannon T Bailey; James Thornton; Dean C Pavlick; Garrett M Frampton; Daniel Lieber; Jared White; Christine Burns; Christine Vietz Journal: PLoS One Date: 2022-03-16 Impact factor: 3.240
Authors: Diego Cortinovis; Umberto Malapelle; Fabio Pagni; Alessandro Russo; Giuseppe Luigi Banna; Elisa Sala; Christian Rolfo Journal: Transl Lung Cancer Res Date: 2021-07
Authors: Hai T Tran; Vincent K Lam; Yasir Y Elamin; Lingzhi Hong; Rivka Colen; Nabil A Elshafeey; Islam S A Hassan; Mehmet Altan; George R Blumenschein; Waree Rinsurongkawong; Melvin J Rivera; Mayra E Vasquez; Brett W Carter; Lauren E Byers; Anne S Tsao; Don L Gibbons; Frank Fossella; Bonnie S Glisson; Jianjun Zhang; John V Heymach Journal: JCO Precis Oncol Date: 2021-08-05
Authors: Petros Christopoulos; Steffen Dietz; Arlou K Angeles; Stephan Rheinheimer; Daniel Kazdal; Anna-Lena Volckmar; Florian Janke; Volker Endris; Michael Meister; Mark Kriegsmann; Thomasz Zemojtel; Martin Reck; Albrecht Stenzinger; Michael Thomas; Holger Sültmann Journal: Transl Lung Cancer Res Date: 2021-05