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Poster session 01

87P - ctDNA analysis as a prognostic factor for early-stage and oligometastatic patients treated with radiotherapy

Date

10 Sep 2022

Session

Poster session 01

Topics

Clinical Research;  Laboratory Diagnostics;  Pathology/Molecular Biology;  Translational Research;  Molecular Oncology;  Secondary Prevention/Screening;  Genetic and Genomic Testing, Counseling;  Response Evaluation (RECIST Criteria);  Radiation Oncology

Tumour Site

Presenters

Guadalupe Alvarez Cifuentes

Citation

Annals of Oncology (2022) 33 (suppl_7): S27-S54. 10.1016/annonc/annonc1037

Authors

G. Alvarez Cifuentes1, A. Santiago1, L. Mendez2, M. Fueyo2, E. López Martínez2, R. Soria2, I. Martín López1, N.S. Durán1, R. Álvarez1, C.G. Lago1, A. Otero Gonzalez3, M. Diñeiro1, R. Capín1, J. Cadiñanos1, R. Cabanillas4

Author affiliations

  • 1 Laboratory Of Molecular Medicine, IMOMA - Instituto de Medicina Oncologica y Molecular de Asturias, 33193 - Oviedo/ES
  • 2 Radiation Oncology, IMOMA - Instituto de Medicina Oncologica y Molecular de Asturias, 33193 - Oviedo/ES
  • 3 Genetic Counselling, IMOMA - Instituto de Medicina Oncologica y Molecular de Asturias, 33193 - Oviedo/ES
  • 4 Precision Medicine, Cabanillas Precision Consulting, 8620 - Wetzikon/CH
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Abstract 87P

Background

High precision radiotherapy techniques, as stereotactic body radiotherapy (SBRT), are increasingly used in the management of non-resectable early-stage lung cancer and also in oligometastatic disease, usually with curative intent. However, there is a need for personalized prognosis biomarkers to stratify patients, adapt treatments and assess their performance. Although, nowadays, more than 50% of cancer patients require radiotherapy, Genomics has not yet been integrated into the clinical practice of radiation oncology.

Methods

We performed germline, tissue- and liquid-biopsy NGS panels on 46 early-stage/oligometastatic cancer patients undergoing radiotherapy to identify personalized genomic biomarkers to be monitored in circulating tumor DNA (ctDNA) from serial liquid biopsies collected during radiotherapy and follow-up. ctDNA signal was compared to patient clinical response, assessed according to RECIST criteria.

Results

The integration of the different genomic tests enabled to determine the origin of the variants identified, essential for successful biomarker selection, only 1/3 of the genomic variants identified by the liquid biopsy panel were real tumor variants. This comprehensive genomic approach revealed variants associated with approved therapies (19.6% of cases) and with investigational therapies/access to clinical trials (60.9%), potential ctDNA biomarkers (100%) and hereditary predispositions to cancer (6.5%). The pre-treatment ctDNA signal was significatively associated with progression-free survival in early-stage and oligometastatic patients (p-value = 0.001). Also, longitudinal ctDNA analysis could be used as a follow-up biomarker, even anticipating other diagnostic tests.

Conclusions

In patients with early stage or oligometastatic disease treated with RT, comprehensive genomic testing showed a wide range of benefits. Moreover, in this cohort of patients ctDNA detection during the treatment and the follow-up has the potential to guide prognosis and to identify the patients who may benefit from further therapeutic interventions.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Instituto de Medicina Oncológica y Molecular de Asturias (IMOMA), S.A.

Funding

Instituto de Medicina Oncológica y Molecular de Asturias (IMOMA), S.A.

Disclosure

All authors have declared no conflicts of interest.

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