Phase II/III blood first assay screening trial (BFAST) in patients (pts) with treatment-naïve NSCLC: Initial results from the ALK+ cohort

Gadgeel, Shirish M.; Mok, T.; Peters, Solange; Alexander, J.A. Alatorre; Leighl, Natasha B.; Sriuranpong, Virote; Pérol, Maurice; Castro, Gilberto de; Nadal, Ernest; Marinis, Filippo de; Han, Ji‐Youn; Yan, Mark; Riehl, Todd; Schleifman, Erica; Stolzmann, Paul; Mocci, Simonetta; Shames, D.; Mathisen, Michael S.; Dziadziuszko, Rafał

doi:10.1093/annonc/mdz394.079

Cited by 39 publications

(45 citation statements)

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“…In a recent study conducted at the MD Anderson Cancer Center (Houston, Texas), it was concluded that NGS from LB can completely replace tissue-based testing at a reduced TAT but only a few genomic rearrangements were included in the study population [20]. Recently, the feasibility of the detection of ALK rearrangements from plasma samples has been demonstrated using the same outsourced test as reported in the present study which highlights the current advanced in implementing liquid biopsy-based sequencing at baseline [21]. However, the sensitivity of LB for the detection of genomic rearrangements, in comparison to tissue-based testing, needs urgent confirmation.…”

Section: Discussionsupporting

confidence: 66%

Prospective evaluation of NGS-based liquid biopsy in untreated late stage non-squamous lung carcinoma in a single institution

et al. 2020

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Background: NGS from plasma samples in non-squamous cell lung carcinoma (NSCC) can aid in the detection of actionable genomic alterations. However, the absolute clinical value of NGS in liquid biopsy (LB) made at baseline is currently uncertain. We assessed the impact of plasma-based NGS using an in-house test and an outsourced test in comparison to a routine molecular pathology workflow. Methods: Twenty-four advanced/metastatic treatment-naïve NSCC patients were prospectively included. NGS analyses were conducted both in-house using the Oncomine cfTNA Panel and in an external testing center using the Foundation Liquid assay. NGS analysis and/or specific molecular based assays were conducted in parallel on tissue or cytological samples. Results: Both LB tests were well correlated. Tissue NGS results were obtained in 67% of patients and demonstrated good correlation with LB assays. Activating EGFR mutations were detected using LB tests in three patients. PD-L1 expression assessed in tissue sections enabled the initiation of pembrolizumab treatment in five patients. Conclusion: NGS from LB is feasible in routine clinical practice using an in-house or an outsourced test at baseline. However, the impact on therapy selection was limited in this small series of patients and LB was not able to replace tissue-based testing in our hands.

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Section: Discussionsupporting

confidence: 66%

Prospective evaluation of NGS-based liquid biopsy in untreated late stage non-squamous lung carcinoma in a single institution

et al. 2020

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“…The results obtained using a commercially available plasma NGS platform revealed a PPV of 100% in 34 patients with advanced-stage NSCLC, including the detection of alterations in EGFR (n = 27), ALK (n = 5) or BRAF (n = 2) 30 . This high PPV means that the detection of a targetable oncogenic variant in a gene like EGFR, ALK, ROS1 or others is clinically actionable and could replace the need for tissue genotyping in some patients 31 . Importantly, for non-targetable variants detected within ctDNA (such as alterations in TP53 or KRAS), whether or not these reliably indicate tumour-derived variants is currently less clear.…”

Section: Genotyping Of Ctdnamentioning

confidence: 99%

Strategies for the successful implementation of plasma-based NSCLC genotyping in clinical practice

et al. 2020

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“…ALK rearrangements were found in 119 patients (5.4%), and 87 out of 119 received treatment with alectinib. This subgroup showed an objective response rate of 87.4% (95% CI: 78.5–93.5%), with a response rate of 75.9% (95% CI: 63.6–88.2%) at 12 months and a median investigator-assessed PFS of 78.4% (95% CI: 69.1–87.7%) [ 40 ].…”

Section: Available Assays and Target Genomic Alterations In Lung Cmentioning

confidence: 99%

The Role of the Liquid Biopsy in Decision-Making for Patients with Non-Small Cell Lung Cancer

Akhoundova

Martinez²,

Musmann

et al. 2020

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Liquid biopsy is a rapidly emerging tool of precision oncology enabling minimally invasive molecular diagnostics and longitudinal monitoring of treatment response. For the clinical management of advanced stage lung cancer patients, detection and quantification of circulating tumor DNA (ctDNA) is now widely adopted into clinical practice. Still, interpretation of results and validation of ctDNA-based treatment decisions remain challenging. We report here our experience implementing liquid biopsies into the clinical management of lung cancer. We discuss advantages and limitations of distinct ctDNA assay techniques and highlight our approach to the analysis of recurrent molecular alterations found in lung cancer. Moreover, we report three exemplary clinical cases illustrating the complexity of interpreting liquid biopsy results in clinical practice. These cases underscore the potential and current limitations of liquid biopsy, focusing on the difficulty of interpreting discordant findings. In our view, despite all current limitations, the analysis of ctDNA in lung cancer patients is an essential and highly versatile complementary diagnostic tool for the clinical management of lung cancer patients in the era of precision oncology.

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Phase II/III blood first assay screening trial (BFAST) in patients (pts) with treatment-naïve NSCLC: Initial results from the ALK+ cohort

Cited by 39 publications

References 0 publications

Prospective evaluation of NGS-based liquid biopsy in untreated late stage non-squamous lung carcinoma in a single institution

Prospective evaluation of NGS-based liquid biopsy in untreated late stage non-squamous lung carcinoma in a single institution

Strategies for the successful implementation of plasma-based NSCLC genotyping in clinical practice

The Role of the Liquid Biopsy in Decision-Making for Patients with Non-Small Cell Lung Cancer

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