Abstract 178TiP
Background
Molecular testing is required for treatment decisions in both late and now early stage NSCLC. Challenges remain in obtaining adequate, high-quality diagnostic tumour tissue samples during initial assessment. Liquid biopsy (LB) and bronchoalveolar lavage (BAL) are minimally invasive sample collection methods that have shown promise as a source of tumor-derived DNA, making them potential alternatives for molecular profiling.
Trial design
AToM-001 (Accelerating Time to Molecular Diagnosis) is a prospective non-therapeutic, minimally invasive study in patients (≥18 years) with suspicious lung nodules or confirmed early-stage NSCLC, when bronchoscopy is performed during diagnostic work-up. Plasma will be collected at baseline, BAL fluid (BALF) will be collected during bronchoscopy. These samples will be analyzed using the comprehensive TSO500 (Illumina, CA, USA) assay. Up to 100 patients will be enrolled. Somatic alterations identified in plasma and BALF will be compared to tumor-derived alterations detected in matched tissue samples. The primary objective is to assess the feasibility of tumor genotyping in BALF for early-stage NSCLC, and its concordance with plasma circulating tumor DNA and tissue-based next-generation sequencing. Additional objectives include establishing feasibility of histologic subtyping and PDL1 assessment in BALF using tumor-derived exosomes. Accrual started in December, 2024.
Legal entity responsible for the study
Princess Margaret Cancer Centre.
Funding
Princess Margaret Cancer Foundation.
Disclosure
T. Zhang: Financial Interests, Institutional, Funding: AstraZeneca. T. Stockley: Financial Interests, Institutional, Funding: AstraZeneca, Janssen. N. Leighl: Financial Interests, Institutional, Funding: MSD, Lilly, AstraZeneca, Janssen Oncology, Novartis, Pfizer. All other authors have declared no conflicts of interest.