2023 North America Conference on Lung Cancer (NACLC) - Posters and Abstracts-PP01.082 Tae Hee Hong NACLC23 Abstract

PP01.082 Tae Hee Hong NACLC23 Abstract

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A study conducted by researchers at Samsung Medical Center in Seoul, Korea, and AstraZeneca and GRAIL, LLC, has found that pre-surgical detection of circulating tumor DNA (ctDNA) can be prognostic in stage I lung adenocarcinoma (LUAD). The study analyzed pre-surgical plasma samples from 895 patients with EGFR/ALK wild-type clinical stage I-II (TNMv8) non-small-cell lung cancer (NSCLC). It was found that 31% of patients with stage I NSCLC and 71% with stage II NSCLC had ctDNA positivity. Additionally, 22% of patients with LUAD, 81% with squamous cell carcinoma, and 81% with other NSCLC subtypes were ctDNA positive. The study also found that ctDNA positivity in stage I LUAD was associated with shorter relapse-free survival, mediastinal nodal upstaging, higher rates of PD-L1 (tumor cell expression) positivity, and grade 3 histology. Higher tumor volume and positron emission tomography (PET) avidity were observed in ctDNA-positive patients. Overall, the study validates pre-surgical ctDNA testing as a means to optimize clinical staging in stage I LUAD, providing a non-invasive way to identify high-risk patients who could benefit from treatment intensification. The findings have important implications for improving pre-surgical staging and treatment strategies in lung adenocarcinoma.

Keywords

Samsung Medical Center

ctDNA

stage I lung adenocarcinoma

LUAD

non-small-cell lung cancer

NSCLC

ctDNA positivity

tumor cell expression

tumor volume

PET avidity