2023 World Conference on Lung Cancer (Posters)-P1.23. Liquid Biopsy Predicts Differential Benefit from First Line Pembrolizumab in Advanced Non-small Cell Lung Cancer

P1.23. Liquid Biopsy Predicts Differential Benefit from First Line Pembrolizumab in Advanced Non-small Cell Lung Cancer - PDF(Slides)

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A study conducted by researchers in Italy suggests that liquid biopsy, a non-invasive method of analyzing tumor markers in the blood, may help predict the benefit of pembrolizumab, an immune checkpoint inhibitor, in patients with advanced non-small cell lung cancer (NSCLC). The standard treatment for these patients is pembrolizumab alone or in combination with chemotherapy, but the duration of benefit varies and combination treatments can be toxic. Currently, clinical selection for combination therapies is based on the expression of a protein called PD-L1, but reliable predictive markers are not available.<br /><br />The study enrolled NSCLC patients expressing PD-L1 at a certain level who were treated with pembrolizumab alone. Liquid biopsies were performed at baseline, after a few weeks of treatment, and at the time of radiological evaluation. The samples were analyzed for cell-free DNA (cfDNA) and genetic alterations using a 56 gene panel. The levels of cfDNA and variant allele fraction (VAF) of tumor-associated genetic alterations were evaluated as predictors of treatment outcome.<br /><br />The results showed that longitudinal liquid biopsy could stratify patients receiving pembrolizumab based on their risk of disease progression and survival. The quantification of cfDNA at an early stage of treatment was found to significantly impact the probability of not progressing after 24 months. The study also integrated molecular and clinical variables to develop predictive models for personalized treatment decisions.<br /><br />The researchers concluded that longitudinal liquid biopsy could be a valuable tool for customizing first-line treatment approaches for advanced NSCLC patients. Further validation of liquid biopsy in prospective studies is needed to confirm its role in clinical decision-making. This study provides insight into the potential use of liquid biopsy in predicting the benefit of immune checkpoint inhibitors and improving treatment strategies for NSCLC patients.

Asset Subtitle

Laura Bonanno

Meta Tag

Speaker Laura Bonanno

Topic Pathology & Biomarkers: Liquid Based Biomarkers

Keywords

liquid biopsy

tumor markers

pembrolizumab

immune checkpoint inhibitor

non-small cell lung cancer

NSCLC

combination therapy

PD-L1

cell-free DNA

genetic alterations