2024 World Conference on Lung Cancer (WCLC) - Posters-P2.11A.06 Tumor-Informed ctDNA Status Guiding 1st-line Immuno-Chemotherapy in Advanced NSCLC: CHOICE-01 Retrospective Analysis

P2.11A.06 Tumor-Informed ctDNA Status Guiding 1st-line Immuno-Chemotherapy in Advanced NSCLC: CHOICE-01 Retrospective Analysis

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The CHOICE-01 study investigated the efficacy of immune checkpoint inhibitors (ICIs) combined with chemotherapy versus chemotherapy alone in patients with treatment-naïve advanced non-small cell lung cancer (NSCLC). This study particularly focused on the role of circulating tumor DNA (ctDNA) as a predictive biomarker to guide first-line treatment. A total of 393 patients with both pre-treatment cancerous tissue and ctDNA sequencing data were analyzed. Tumor-informed ctDNA positivity, which indicates the presence of tissue-derived variants in plasma, served as a key marker.<br /><br />Results from the study highlighted that patients with ctDNA-positive status had improved outcomes with ICI-chemo compared to chemotherapy alone, as shown by the progression-free survival (PFS) and overall survival (OS) metrics. Specifically, patients who were ctDNA positive and received ICI-chemo had a median PFS of 8.3 months versus 5.5 months for those who received chemotherapy alone. In terms of OS, the ctDNA-positive group had a median of 21.4 months compared to 14.3 months for those on chemotherapy alone.<br /><br />The study also assessed the dynamic changes in ctDNA status at specific time points and found that patients whose ctDNA status changed from positive to negative (clearance) demonstrated significantly better OS and PFS outcomes than those with persistently positive ctDNA. These findings underline the utility of tumor-informed ctDNA as a promising predictive tool for tailoring first-line treatments in advanced NSCLC, helping to identify which patients may benefit most from the ICI-chemotherapy combination. Overall, ctDNA analysis could facilitate personalized treatment plans, potentially improving patient outcomes in this cancer type.

Asset Subtitle

Zhijie Wang

Meta Tag

Speaker Zhijie Wang

Topic Metastatic NSCLC – Immunotherapy

Keywords

immune checkpoint inhibitors

chemotherapy

non-small cell lung cancer

circulating tumor DNA

predictive biomarker

progression-free survival

overall survival

tumor-informed ctDNA

personalized treatment

first-line treatment