2024 Asia Conference on Lung Cancer (ACLC) - Poster & ePosters-PP02.51

PP02.51 - Jia-tao Zhang

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The study investigates the prognostic significance of circulating tumor DNA (ctDNA) as an indicator of molecular residual disease (MRD) in non-small cell lung cancer (NSCLC) patients. ctDNA, detectable in the peripheral blood, offers the potential to predict disease recurrence earlier than traditional imaging methods—3 to 6 months ahead and occasionally more than a year. This early detection of MRD is crucial for identifying patients at high risk of rapid recurrence, those requiring swift clinical intervention.<br /><br />The research, conducted at the Guangdong Lung Cancer Institute and Geneplus-Beijing Institute, involved 261 stage I-III NSCLC patients who had undergone surgery. The study focused on the lead time, which is the period from the initial detection of postoperative MRD to confirmed radiographic recurrence, and examined how this correlates with both clinicopathological factors and the quantitative characteristics of ctDNA. Key quantitative metrics considered were ctDNA concentration, average/maximum variant allele frequency (VAF), ctDNA level in hGE/ml, and the number of mutations.<br /><br />Key findings revealed significant correlations between lead times and ctDNA levels and maximum VAF. High maximum VAF (greater than 0.55%) and ctDNA levels (above 13.0 hGE/ml) are associated with a significantly shorter lead time for recurrence, demonstrating the utility of these metrics in identifying patients at risk of rapid recurrence within three months post-surgery.<br /><br />The study concludes that these ctDNA characteristics could guide the development of early intervention strategies, enhancing patient prognosis by identifying worsening conditions sooner, allowing for timely therapeutic responses. This research builds on previous findings that suggest the potential for ctDNA to signal long-term remission or potentially curative outcomes in localized NSCLC when MRD is undetectable.

Keywords

circulating tumor DNA

molecular residual disease

non-small cell lung cancer

early detection

prognostic significance

lead time

variant allele frequency

postoperative recurrence

therapeutic intervention

patient prognosis