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
497P - Sintilimab in combination with anlotinib in advanced NSCLC treated with first-line PD-1 antibodies: An open, single-arm, phase II trial
Presenter: Ying Jin
Session: Poster Display
Resources:
Abstract
498P - Frailty-adjusted life expectancy and survival in older lung cancer patients: A large-scale electronic health-record based study
Presenter: Thao Tu
Session: Poster Display
Resources:
Abstract
499P - Long-term survival and treatment (tx) patterns after first-line (1L) osimertinib in patients (pts) with epidermal growth factor receptor (EGFR) mutation-positive (m) advanced non-small cell lung cancer (NSCLC): Japanese cohort of a global real-world (rw) observational study
Presenter: Daichi Fujimoto
Session: Poster Display
Resources:
Abstract
500P - The effectiveness and safety of durvalumab after chemoradiotherapy for locoregional recurrence of completely resected non-small cell lung cancer: Real-world, multicenter, observational study (NEJ056)
Presenter: Hidehito Horinouchi
Session: Poster Display
Resources:
Abstract
501P - One-year survival outcomes of unresectable stage III non-small cell lung cancer patients who underwent PD-1 inhibitor plus chemo as induction therapy
Presenter: Xin Wang
Session: Poster Display
Resources:
Abstract
502P - Impact of sarcopenia on the outcome of patients with locally advanced non-small cell lung cancer treated with chemoradiotherapy followed by durvalumab
Presenter: Kentaro Tamura
Session: Poster Display
Resources:
Abstract
503P - Clinical outcomes by infusion timing of immune checkpoint inhibitors in patients with locally advanced NSCLC
Presenter: TSUYOSHI HIRATA
Session: Poster Display
Resources:
Abstract
504P - Real-world outcomes with induction systemic therapy for stage III in eligible for upfront local therapy: Pre vs post immunotherapy era in a tertiary referral centre
Presenter: Praveen Kumar Marimuthu
Session: Poster Display
Resources:
Abstract
505P - Neoadjuvant PD-1 inhibitor (tislelizumab) plus platinum–etoposide in patients with limited-stage small cell lung cancer: A phase II trial
Presenter: Junjie Hu
Session: Poster Display
Resources:
Abstract
506P - Intrathoracic progression is still the most dominant failure pattern after first-line chemo-immunotherapy in extensive-stage small-cell lung cancer: Implications for thoracic radiotherapy
Presenter: Byoung Hyuck Kim
Session: Poster Display
Resources:
Abstract