2024 World Conference on Lung Cancer (WCLC) - Posters-P3.06D.05 Stratifying Risk in Oligoprogressive EGFR-Mutated Non-Small Cell Lung Cancer: The Role of ctDNA

P3.06D.05 Stratifying Risk in Oligoprogressive EGFR-Mutated Non-Small Cell Lung Cancer: The Role of ctDNA

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The document details a retrospective study conducted between 2013 and 2024 at Mexico’s National Cancer Institute and Medica Sur Hospital, focusing on advanced lung adenocarcinoma with EGFR mutations treated with first-line EGFR-TKI (1st-3rd gen). The study investigates the role of circulating tumor DNA (ctDNA) as a prognostic marker during oligoprogression, a stage where the disease progresses regionally rather than systemically.<br /><br />Key findings include the significant prognostic value of ctDNA in patients with extracranial EGFR-oligoprogressive non-small cell lung cancer (NSCLC). Among 84 patients experiencing oligoprogression on first-line TKI therapy, 70 underwent liquid biopsies, with 56% testing ctDNA positive. Detectable ctDNA was associated with poorer outcomes, indicating it as a strong predictor of disease status and progression.<br /><br />The primary endpoint was progression-free survival-2 (PFS2), measuring time from oligoprogression to the subsequent disease progression or death. The secondary endpoint was post-progression survival (PPS), defined as the time from oligoprogression to death from any cause. Results highlighted that patients with negative ctDNA in liquid biopsies had significantly longer PFS2 and PPS compared to ctDNA-positive patients. For instance, median PFS2 was 4.99 months for ctDNA-positive patients versus 11.73 months for ctDNA-negative patients.<br /><br />The study underscores the use of ctDNA as a crucial tool in guiding clinical decisions. Positive ctDNA results suggest the need for alternative treatments, while negative results favor prolonged EGFR-TKI and local therapies. Future research should focus on prospective studies to confirm ctDNA's prognostic value and explore new treatment avenues for oligoprogressive disease.

Asset Subtitle

Alberto Guijosa

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Speaker Alberto Guijosa

Topic Pathology & Biomarkers

Keywords

retrospective study

advanced lung adenocarcinoma

EGFR mutations

circulating tumor DNA

oligoprogression

liquid biopsy

progression-free survival

post-progression survival

prognostic marker

EGFR-TKI therapy