Abstract 3046
Background
We conduct a trial using neoadjuvant chemotherapy (nCRT) and verify the value of ctDNA and CTC as biomarkers for tumor response in the nCRT treatment of locally advance gastric adenocarcinoma.
Methods
Twenty milliliters of plasma were collected at 3 points: before nCRT; after 2 cycles of nCRT; and after surgery. Firefly ctDNA NGS assays were used to track ctDNA mutations previously characterized in paired tumor tissue by massively parallel sequencing. Using patient-specific mutation derived from exome sequencing of tumor tissues samples, bespoke amplicon-based sequencing panel were synthesized and used for ctDNA profiling. CTCs in 7ml peripheral blood were separated by a negative enrichment method and identified by FISH using two frequently proliferation chromosome probes, CEP8 and CEP17. Meanwhile, the HER2 expression in CTCs was determined by FISH and immunofluorescence. CEP8+ and/or CEP17+, DAPI+, CD45- cell were justified as CTCs, HER2 FISH+ or HER2 IF+, DAPI+, CD45- cells were justified as HER2 positive CTCs.
Results
In comparison to basal line value of pre-chemotherapy blood, the ctDNA loading were decreased in post-chemotherapy specimens of 8 patients with TRG1 by histopathological grading or partial and complete response by CT scan. However, the amount of ctDNA in 25 patients diagnosed as TRG 2 or 3 showed minor changes during the neoadjuvant therapy. 22 have integral FISH data (CTCs range from 0-29, average: 4.9, 2.7 and 4.0, positive rate: 82%,73% and 73%), and 12 have integral HER2 data (CTCS range from 0-9, average: 2.9, 2.2 and 2.9, positive rate: 25%, 50% and 33%). The dynamic variations were coincidence to the clinical evaluation. For HER2, we found three positive model in CTCs, single FISH or IF positive or double positive. Double positive HER2-CTCs are found in some patients. By negative enrichment and FISH, CTCs can be detected at a low cutoff of 2 cells in 73%∼82% patients.
Conclusions
The ctDNA and CTC alteration during neoadjuvant therapy are consistent with histopathological grading and response assessmentand and can be surrogate markers to prediction efficacy of nCRT for GC.
Clinical trial identification
NCT03425058 11/02/2018.
Editorial acknowledgement
Legal entity responsible for the study
The author.
Funding
Beijing Municipal Administration of Hospital Clinical Medicine Development of Special Funding Support (ZYLX201701).
Disclosure
The author has declared no conflicts of interest.
Resources from the same session
3911 - Defining a SUV decrease cut-off in PET/CT response monitoring after one cycle of preoperative breast cancer chemotherapy
Presenter: Marcin Kubeczko
Session: Poster Display session 2
Resources:
Abstract
1849 - Effect of thioredoxin 1 quantity detection to complement the mammography in breast cancer diagnosis
Presenter: Younju Lee
Session: Poster Display session 2
Resources:
Abstract
2221 - Identification of ultralow risk breast cancer patients (probable overdiagnosis)
Presenter: Salvador Gamez Casado
Session: Poster Display session 2
Resources:
Abstract
5291 - Prevalence of Vitamin D3 deficiency among women with early breast cancer receiving chemotherapy in an oncology dayward.
Presenter: Warner Finstad
Session: Poster Display session 2
Resources:
Abstract
4247 - Changes in ER pathway activity score during neoadjuvant letrozole to assess therapy response and predict disease free survival (DFS) in ER positive breast cancer patients
Presenter: Arran Turnbull
Session: Poster Display session 2
Resources:
Abstract
568 - Second primary malignancies in patients with breast cancer.
Presenter: Carlos Erasun Lecuona
Session: Poster Display session 2
Resources:
Abstract
1428 - Phase II randomized trial of neoadjuvant trastuzumab and pertuzumab (TP) with either palbociclib + letrozole (Pal+L) or paclitaxel (Pac) for elderly patients with estrogen receptor & HER2 positive (ER+/HER2+) Breast Cancer (BC) (International Breast Cancer Study Group IBCSG 55-17, TOUCH)
Presenter: Laura Biganzoli
Session: Poster Display session 2
Resources:
Abstract
1479 - Neoadjuvant HER2-targeted therapy with or without immunotherapy with pembrolizumab (neoHIP): an open label randomized phase 2 trial
Presenter: Heather McArthur
Session: Poster Display session 2
Resources:
Abstract
1481 - A randomized phase 2 study of peri-operative ipilimumab, nivolumab and cryoablation versus standard care in women with residual, early stage/resectable, triple negative breast cancer after standard-of-care neoadjuvant chemotherapy
Presenter: Heather McArthur
Session: Poster Display session 2
Resources:
Abstract
4334 - ALEXANDRA/IMpassion030: A phase 3 study of standard adjuvant chemotherapy with or without atezolizumab in early stage triple negative breast cancer.
Presenter: Michail Ignatiadis
Session: Poster Display session 2
Resources:
Abstract