Loading...
The clincial utility of circulating free DNA (cfDNA) analysis in non-small cell lung cancer (NSCLC) in the United Kingdom
Greystoke, A. Carter, Mathew Griffiths, W. Laviste, Glenda Ortega-Franco, Ana Rafee, Shereen Hannaway, N. Bridgewood, A. Hall, S.
Greystoke, A.
Carter, Mathew
Griffiths, W.
Laviste, Glenda
Ortega-Franco, Ana
Rafee, Shereen
Hannaway, N.
Bridgewood, A.
Hall, S.
Citations
Altmetric:
Abstract
Background: cfDNA has the potential to be used as diagnostic, predictive, prognostic and
pharmacodynamic biomarker for NSCLC. Next Generation Sequencing of cfDNA is moving from the research setting to routine clinical use. As tumour genomics and burden will differ in the clinic from trials it is important to determine performance in this setting.
Methods: 17ml of blood was taken from 230 patients with known or suspected NSCLC
treated at The Christie and Newcastle upon Tyne Hospitals NHS Trusts from June
2019. Samples were transported to Foundation Medicine and analysed on a commercial
hybrid-capture NGS platform for 70 oncogenes. Clinical details and rationale
for test were extracted from clinical notes.
Results: Most patients were either untreated or had received 1 line of therapy (54% and
25% respectively). Histology was adenocarcinoma in 68%; squamous cancer in 13%,
other in 9% and no histology in 10%. In 35% the rationale for testing was to avoid a
contemporaneous biopsy (either failure of initial biopsy or inability to safely perform
15%, or rebiopsy on progression of targeted therapy 20%). Median time from collection
to report was 13 days (range 4 to 21) with 85% received within 14 days; the failure rate
was 5%, mostly due to cfDNA levels <20ng/ml. The number of abnormalities reported
was 0 in 13%, 1 in 22%, 2 in 28% and 3 or more in 36% of patients. The median variant
allele fraction (VAF) was 1.6% (range 0.11-91); however, 25% of cases had less than 0.5%
VAF. Potentially actionable findings using the ESCAT scale were found for Tier 1: 22%
(20% already known) Tier 2:14% and Tier 3: 4% of patients. 5 known fusions were not
detected (4 ALK; 1 ROS-1) although 3 patients were on therapy at sampling.
Conclusions: In community practice results of cfDNA sampling are similar to reported in
previous research series. 18% of patients either had failed analysis or no detectable abnormality.
Only patients with EGFR mutations were able to access standard of care treatments
but some patients were able to avoid biopsies or be routed to appropriate trials.
Description
Date
2020
Publisher
Collections
Files
Loading...
From UNPAYWALL
Adobe PDF, 88.71 KB
Keywords
Type
Meetings and Proceedings
Citation
Greystoke A, Carter M, Griffiths W, Laviste G, Ortega-Franco A, Rafee S, et al. 1337P The clincial utility of circulating free DNA (cfDNA) analysis in non-small cell lung cancer (NSCLC) in the United Kingdom. Annals of Oncology. 2020;31:S859-S.