2024 World Conference on Lung Cancer (WCLC) - ePosters-EP.04E.02 Quantification of Cerebrospinal Fluid Tumor DNA in Lung Cancer Patients with Suspected Leptomeningeal Carcinomatosis

EP.04E.02 Quantification of Cerebrospinal Fluid Tumor DNA in Lung Cancer Patients with Suspected Leptomeningeal Carcinomatosis

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This study explores the quantification of cerebrospinal fluid (CSF) tumor DNA in lung cancer patients with suspected leptomeningeal carcinomatosis (LMC) using the CAncer Personalized Profiling by deep Sequencing (CAPP-Seq) method. The research addresses the challenges of diagnosing LMC, a condition characterized by metastasis of cancer to the membranes surrounding the brain and spinal cord. LMC often responds poorly to targeted therapies, making early and accurate diagnosis crucial.<br /><br />The study utilizes 85 CSF and blood samples from 25 advanced lung cancer patients to evaluate the effectiveness of CAPP-Seq against traditional methods like cytology. The findings reveal that CSF-tDNA detection offers higher sensitivity, diagnosing LMC in some patients who were cytology-negative. The use of CAPP-Seq not only enhances diagnostic accuracy but also aids in predicting patients' responses to EGFR-targeted therapies such as Osimertinib.<br /><br />Additionally, the study examines the relationship between CSF-tDNA levels and overall survival rates. Patients with detectable CSF-tDNA at initial lumbar punctures generally had poorer survival outcomes compared to those with undetectable levels. The study also identifies spatial heterogeneity in resistance mechanisms to EGFR-TKIs, indicating that resistance identified in plasma ctDNA might not be identical to those present in CSF-tDNA.<br /><br />Ultimately, the research suggests that CAPP-Seq can serve as a valuable tool for diagnosing LMC, predicting therapeutic outcomes, and tailoring strategies that account for diverse resistance mechanisms. This approach is anticipated to improve patient management and treatment efficacy in lung cancer cases where CNS metastasis is a concern. The study is supported by grants from institutions like Stanford University and Kanazawa University and acknowledges contributions from numerous researchers and organizations.

Asset Subtitle

Shigeki Nanjo

Meta Tag

Speaker Shigeki Nanjo

Topic Screening and Early Detection

Keywords

cerebrospinal fluid

tumor DNA

lung cancer

leptomeningeal carcinomatosis

CAPP-Seq

diagnostic accuracy

EGFR-targeted therapies

spatial heterogeneity

resistance mechanisms

central nervous system metastasis