Abstract 960P
Background
HCC is an aggressive malignancy, accounting for ∼90% of primary hepatic cancers. While surgical resection and liver transplantation (Tx) can be curative, 8-20% of post-Tx and 40-70% of post-resection patients recur. Here we sought to analyze the utility of longitudinal testing with ctDNA in patients (pts) with HCC.
Methods
This multicenter study retrospectively analyzed 227 plasma samples from 66 pts with HCC. The curative-intent surgeries included liver Tx (41/66, 62%) and hepatectomy (23/66, 34%); two pts (3%) who were inoperable received liver directed and systemic targeted therapy. Five of the 41 post-Tx pts received additional resection for oligometastatic recurrence prior to ctDNA testing. The cohort was analyzed based on 3 mutually exclusive sub-cohorts: Cohort A (N=34): recurrence monitoring after curative liver Tx; Cohort B (N=25): recurrence monitoring after curative-intent surgical resection; Cohort C (N=7): pts with known recurrence monitored for treatment response/disease progression. Longitudinal ctDNA testing was performed using the SignateraTM bespoke mPCR NGS assay.
Results
The cohort distribution included: 28 (42.4%) / 21 (31.8%) / 7 (10.6%) / 9 (13.6%) stage I/II/III/IV pts with a median age of 67 years (range: 21-84); median follow-up of 584 days (range: 79 - 1537). In cohort A, all patients were ctDNA-negative and remained recurrence-free.In cohort B, postsurgical ctDNA was detected in 9 (36%) patients, 6 experienced clinical recurrence and 3 had limited follow-up. The median lead time of ctDNA detection over clinical recurrence was 52 days (range: 0-262). Among the ctDNA-negative patients (N=16), only one pt experienced clinical recurrence; this was >1 year after the last ctDNA test. In cohort C, on-treatment ctDNA dynamics were concordant with treatment response in 4 pts as measured by imaging. The remaining 3 pts were persistently ctDNA-negative on/shortly after systemic therapy.
Conclusions
Longitudinal testing with ctDNA is critical in identifying early recurrence post surgical resection. Similarly, monitoring treatment response in the palliative setting can help resolve ambiguous imaging results.
Clinical trial identification
N/A
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
C. Brdiges: Financial Interests, Institutional, Advisory Board, Full-time employment and stock or option to own stock at Natera, Inc. Name: Antony Tin: Natera, Inc.. T. Tin, C. Brewer, A. Jurdi, M.C. Liu: Financial Interests, Personal and Institutional, Advisory Board: Natera Inc. All other authors have declared no conflicts of interest.
Resources from the same session
978P - Post-progression outcomes of advanced HCC patients (aHCC pts) treated with first-line atezolizumab/bevacizumab (A/B)
Presenter: Claudia Fulgenzi
Session: Poster session 18
979P - Safety interim analyses of first-line systemic therapy with atezolizumab plus bevacizumab (ATZ+BEV) in patients from Spain with unresectable hepatocellular carcinoma (HCC): Phase IIIb ATHECA
Presenter: Maria Elisa Reig Monzon
Session: Poster session 18
980P - Neutrophil count predicts the complete response after transarterial chemoembolization related to favorable outcome in hepatocellular carcinoma
Presenter: Young Mi Hong
Session: Poster session 18
981P - The response of portal vein tumoral thrombosis to moderately hypo-fractionated radiotherapy using intensity modulated radiotherapy
Presenter: Ahmad Abdel-Azeez
Session: Poster session 18
982P - Transarterial chemoembolization with idarubicin versus epirubicin for hepatocellular carcinoma: An interim analysis of a multicentre, randomized controlled phase III trial
Presenter: Zhewei Zhang
Session: Poster session 18
983P - Safety and efficacy of durvalumab plus hepatic artery infusion chemotherapy in HCC with severe portal vein tumor thrombosis (Vp3/4) – the DurHope study
Presenter: Ming Zhao
Session: Poster session 18
984P - Comparative study of scoring systems predicting outcome of transarterial chemoembolization for hepatocellular carcinoma: A nationwide cohort study
Presenter: Jo Kook Lee
Session: Poster session 18
987P - Safety and efficacy of lenvatinib in patients with unresectable hepatocellular carcinoma (uHCC) in real-world practice in Korea
Presenter: Wonseok Kang
Session: Poster session 18
988P - Burden of primary liver cancer in the Middle East and North Africa Region from 1990 to 2019
Presenter: Ahmed Hafez Allam
Session: Poster session 18