Liquid biopsy (LB), or cell-free DNA analysis (cfDNA), is a novel non-invasive approach to detect molecular alterations (MAs) in cancer patients (pts) allowing personalized therapy. It has been validated in clinical trials, however, the real-world evidence is still in its initial steps. The aim is to evaluate the outcomes of LB in ICP (International cancer pts) with the intention of offering novel treatment options.
We included in this prospective real-world study pts with advanced solid cancers admitted to the international department of Gustave Roussy starting December 2021. cfDNA was extracted from peripheral blood using streck tubes which were sent to FoundationOne®Liquid CDx for sequencing.
47 pts were included with a median age of 60.5 years. 46.8% (22 pts) were males. Gastrointestinal cancers were the most common neoplasms in 20 (42.5%) followed by thoracic tumors in 9 (19.1%). Pts were from 7 nationalities (29 from Kuwait (61.7%), 11 from Algeria (23.4%), and 7 from other countries (14.9%). 17 were treatment-naïve (36.2%), 34 were previously treated with chemotherapy (73.3%), and 16 (34%) with immunotherapy. On the day of LB, 43 had distant metastases (91.5%) while 24 had an ECOG score of 0-1 (51.1%). Among the 47 pts, 2 (4.2%) had insufficient cfDNA to perform the LB. Median number of MA detected was 5. Tumor mutational burden (TMB) ≥ 10 was found in 7 (14.9%) pertaining an option for immunotherapy. Beyond TMB, 10 MAs were detected with available therapeutic options in 9 (19.1%). The following MAs were confirmed: KRAS G12C (2, lung and pancreatic), EGFR (1, lung), IDH1 (1, cholangiocarcinoma), BRAF (2, angiosarcoma and colon), BRCA2 (1, pancreatic), PIK3CA (2, breast) and FGFR3 (1, bladder). In total, 15 pts with 17 MAs were offered an innovative approach based on LB (31.9%). Also, an additional 22 MAs were detected in 16 pts with available phase I or II clinical trials. A JAK2 mutation was detected in a pt which necessitated hematology referral.
LB proved to be an easy and attractive tool to pinpoint MAs with a significant diagnostic and therapeutic impact. It is an alternative mean to carefully spot MAs in ICP with 31.9% of pts offering them additional therapeutic options.
Clinical trial identification
Legal entity responsible for the study
Has not received any funding.
All authors have declared no conflicts of interest.