2023 World Conference on Lung Cancer (Posters)-P1.23. Cerebrospinal Fluid ctDNA Based Therapy Associated with Survival of CNS Metastases in Advanced NSCLC: A Large Scale, Comprehensive Study

P1.23. Cerebrospinal Fluid ctDNA Based Therapy Associated with Survival of CNS Metastases in Advanced NSCLC: A Large Scale, Comprehensive Study - PDF(Abstract)

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Researchers conducted a large-scale study to explore the use of cerebrospinal fluid (CSF) circulating-tumor DNA (ctDNA) as a biomarker for central nervous system (CNS) metastases in advanced non-small cell lung cancer (NSCLC) patients. The study followed a cohort of 584 patients with NSCLC and CNS metastases. All patients received CSF ctDNA sequencing, as well as matched tissue and plasma ctDNA sequencing. <br /><br />The results showed that CSF ctDNA was highly concordant with metastatic brain tumors in NSCLC and captured potentially actionable alterations of CNS metastases. CSF ctDNA positivity, defined as the presence of at least one detectable alteration, was influenced by various factors including CSF cytology, systemic disease burden, and prior treatments. Radiologic features from brain MRI imaging were also significantly correlated with CSF ctDNA levels.<br /><br />In a multivariate model, CSF ctDNA positivity and ctDNA burden independently predicted worse overall survival (OS). Among patients with matched targeted therapy, those with undetectable CSF ctDNA had the longest OS. Among patients with detectable CSF ctDNA, receiving CSF-matched therapy showed longer OS compared to not receiving targeted therapy. The study also identified CSF-unique alterations that indicated shorter OS and suggested CNS-specific resistance.<br /><br />The research findings highlight the potential of CSF ctDNA as a prognostic biomarker and as a tool to match targeted therapy in CNS metastases. CSF ctDNA was also shown to be a potential early indicator of intracranial disease progression. <br /><br />Overall, this study provides valuable insights into the use of CSF ctDNA as a liquid-based biomarker for CNS metastases in advanced NSCLC patients.

Asset Subtitle

Mei-Mei Zheng

Meta Tag

Speaker Mei-Mei Zheng

Topic Pathology & Biomarkers: Liquid Based Biomarkers

Keywords

CSF ctDNA

biomarker

CNS metastases

NSCLC patients

metastatic brain tumors

CSF cytology

targeted therapy

overall survival

intracranial disease progression

liquid-based biomarker