Abstract 4557
Background
Genomic instability as characteristic for malignant transformation can be identified by quantitative sequencing. Cell-free tumor DNA (cfDNA) is a minimal invasive biomarker that can be used for tumor and therapeutic monitoring. This study evaluates quantitative cfDNA in patients (pts) with pancreatic cancer (PDAC) as an early therapeutic outcome marker.
Methods
In this prospective study plasma samples of 59 PDAC pts were collected in two centers throughout treatment with either FOLFIRINOX (n = 35) or Gemcitabine/nab-paclitaxel (n = 24). Additionally in 17 pts with FOLFIRINOX samples were collected during and 8 hours after treatment initiation. CNI scoring assays were used to quantify cfDNA. The results were correlated to CT/MRT imaging (RECIST 1.1) after 8-12 weeks, or monthly CA 19-9 and CEA values.
Results
At base-line in 55 out of 59 samples cfDNA could be detected. The CNI scores in metastasized PDAC were significant higher in comparison to locally advanced tumors (p = 0.009), however no differences occurred between the centers, therapy regime or outcome. Results to sensitivity, specificity, PPV and accuracy of CNI scores after 3 month of treatment are given in the table. Especially in sensitivity and accuracy CNI score show an advantage above classical tumor marker. Moreover, a dramatic cytolytic burst with subsequent significant increased CNI score 8 hours after treatment initiation with FOLFIRINOX was observed in 3/4 pts with PR, 1/4 pts with SD, compared to 0/9 pts with PD. This makes the CNI sore a very early predictor of treatment failure sensitive during first administration of chemotherapy.Table:
717P CNI and CA19-9 for prediction of therapy outcome
FOLFIRINOX CNI | FOLFIRINOX CA19-9 | Gem/nab CNI | Gem/nab CA19-9 | |
---|---|---|---|---|
Sens PD (%) | 73 | 36 | 50 | 18 |
Spec PD (%) | 88 | 88 | 93 | 62 |
PPV (%) | 89 | 100 | 86 | 40 |
Conclusions
Determination of cfDNA in the serum predicts treatment outcome more precise and earlier compared to classical tumor marker such as imaging or CA19-9 in PDAC patients. Prediction of non responsivness to therapy might even be possible after the first administration of FOLFIRINOX.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
3180 - Genomic analysis of hepatobiliary lithiasis associated cholangiocarcinoma revealed a distinct subtype feature.
Presenter: Lunda Gu
Session: Poster Display session 2
Resources:
Abstract
4891 - Comparison of the impact of stereotactic body radiation therapy vs. radiofrequency ablation on liver function in patients with single hepatocellular carcinoma: A propensity score matching analysis
Presenter: Masayuki Ueno
Session: Poster Display session 2
Resources:
Abstract
3203 - Exploratory analysis based on tumor location and early metabolic tumor response of REACHIN, a randomized double-blinded placebo-controlled phase II trial of regorafenib after failure of gemcitabine/platinum-based chemotherapy for advanced and metastatic biliary tract tumors.
Presenter: Anne Demols
Session: Poster Display session 2
Resources:
Abstract
1602 - Predictive Value of Neutrophil-Lymphocyte Ratio (NLR) And Platelet-Lymphocyte Ratio (PLR) In Hepatocellular Carcinoma (HCC) Patients Treated with Nivolumab (N)
Presenter: Sirish Dharmapuri
Session: Poster Display session 2
Resources:
Abstract
2848 - Preliminary Safety and Pharmacokinetics of a New Lysosomotropic Oral Agent, GNS561, in a First-in-Human Study in Advanced Primary Liver Cancer Patients
Presenter: Ahmad Awada
Session: Poster Display session 2
Resources:
Abstract
1396 - A phase 1b trial of lenvatinib (LEN) plus pembrolizumab (PEMBRO) in unresectable hepatocellular carcinoma (uHCC): updated results
Presenter: Josep Llovet
Session: Poster Display session 2
Resources:
Abstract
1139 - Multicentric prospective study of validation of angiogenesis-related gene polymorphisms in HCC patients treated with sorafenib: Final results of INNOVATE study
Presenter: Andrea Casadei-gardini
Session: Poster Display session 2
Resources:
Abstract
4688 - Prognostic and predictive factors from the phase 3 CELESTIAL trial of cabozantinib (C) versus placebo (P) in previously treated advanced hepatocellular carcinoma (aHCC)
Presenter: Tim Meyer
Session: Poster Display session 2
Resources:
Abstract
1492 - A phase Ib study of pembrolizumab following trans-arterial chemoembolization (TACE) in hepatocellular carcinoma (HCC): PETAL.
Presenter: David Pinato
Session: Poster Display session 2
Resources:
Abstract
3159 - Anlotinib for advanced hepatocellular carcinoma: interim results from the phase II ALTER0802 study
Presenter: AiPing Zhou
Session: Poster Display session 2
Resources:
Abstract