Abstract 417P
Background
An increasing amount of research suggests that the presence of minimal residual dis-ease (MRD) after curative-intent surgery for early-stage cancers is associated with disease recurrence. Circulating tumor DNA (ctDNA) has emerged as a promising biomarker for MRD assessment in patients with colorectal cancer (CRC) who have undergone surgery or completed adjuvant therapy. MRD tests are already available for use in clinics; however, treatment decisions following MRD results obtained in routine practice are infrequently described.
Methods
In this study, we report on the real-world clinical use of Guardant Reveal, a validated tissue-agnostic MRD assay which assesses genomic mutations as well as methylation sigantures, in the first 82 consecutive patients (102 samples) with CRC tested in Asia and the Middle East.
Results
Overall, 24% of patients had ctDNA detected in their first MRD test, and the frequency of ctDNA positivity increased with increasing tumor stage. Among all ctDNA-positive samples, 48% had evidence of MRD only through the detection of methylation signals, while 26% had both genomic alterations and methylation signals. In patients with stage II CRC, 78% of tests were ordered within 12 weeks after resection, while for patients with stage III disease, 63% of tests were ordered during surveillance. We also describe real-life clinical cases utilizing tissue-agnostic MRD assessment. Most of the physicians included MRD test results in the treatment pla.
Conclusions
Through retrospective analysis of real-world data, we describe how physicians in Asia and the Middle East currently apply a commercially available tissue-agnostic MRD assay in clinical decision-making for patients after surgical resection of colorectal cancer. The addition of methylation assessment to somatic mutation detection contributed to the detection of MRD in samples without mutation. Results from prospective randomized studies will further define the clinical role of MRD detection in resectable CRC. Evidence for tissue-agnostic MRD assays is building across tumor types with continuous improvements in sensitivity and specificity.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
S.S. Jain, S. Hsing, N. Joshi: Financial Interests, Personal, Full or part-time Employment: Guardant Health. All other authors have declared no conflicts of interest.
Resources from the same session
238P - Enfortumab-vedotin for metastatic urothelial carcinoma refractory to platinum-based chemotherapy and immune checkpoint inhibitors: A single institution experience
Presenter: Yuki Endo
Session: Poster Display
Resources:
Abstract
239P - Elevated baseline C-reactive protein is a prognostic indicator for OS in patients with metastatic non clear cell renal cell carcinoma treated with systemic therapy
Presenter: Ryuichi Mizuno
Session: Poster Display
Resources:
Abstract
240P - Efficacy and safety of first-line combination therapy with ipilimumab + nivolumab for metastatic renal cell carcinoma in a single institution in Japan
Presenter: Naoya Nagaya
Session: Poster Display
Resources:
Abstract
241P - First-line cabozantinib in metastatic renal cell carcinoma (mRCC): A real-world exploratory study from eastern India
Presenter: Tamojit Chaudhuri
Session: Poster Display
Resources:
Abstract
244P - Clinicopathologic feature and treatment outcome of metastatic non clear cell kidney cancer: A single centre experience from India
Presenter: Somnath Roy
Session: Poster Display
Resources:
Abstract
245P - The role of TGF-β in the formation of the protumor phenotype of circulating neutrophils at different stages of renal cancer
Presenter: Ilseya Myagdieva
Session: Poster Display
Resources:
Abstract
246P - Impact of renal impairment on first-line treatment in metastatic urothelial cancer
Presenter: Stephanie Wakeling
Session: Poster Display
Resources:
Abstract
247P - Adjuvant chemoradiotherapy in the management of bladder adenocarcinoma compared to multiple treatment modalities
Presenter: Othman Mohammed
Session: Poster Display
Resources:
Abstract
248P - Screening zinc homeostasis-related genes identifies metallothionein 1H (MT1H) as a potential prognostic biomarker in clear cell renal cell carcinoma (ccRCC)
Presenter: Eyad Al Masoud
Session: Poster Display
Resources:
Abstract
249P - The prognostic utility of Progestogen associated Endometrial protein (PAEP) gene expression in clear cell renal cell carcinoma (ccRCC)
Presenter: Leen Lataifeh
Session: Poster Display
Resources:
Abstract