WCLC 2025 - Posters & ePosters-P2.06.78 Using a Personalized, Tumor-Informed Circulating DNA (ctDNA) to Monitor Treatment Outcomes in Lung Cancer Patients

P2.06.78 Using a Personalized, Tumor-Informed Circulating DNA (ctDNA) to Monitor Treatment Outcomes in Lung Cancer Patients

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This study investigates the use of personalized, tumor-informed circulating tumor DNA (ctDNA) testing to monitor treatment outcomes and recurrence in lung cancer patients, focusing on non-small cell lung cancer (NSCLC). Traditional imaging methods such as MRI, CT, and PET scans, while standard for detecting cancer progression or treatment response, have limitations including radiation exposure, high costs, and sometimes inconclusive results. Tumor-informed ctDNA testing emerges as a promising alternative by detecting molecular residual disease and recurrence risk earlier than imaging.<br /><br />In a retrospective analysis of 88 lung cancer patients undergoing routine ctDNA testing, 31 evaluable NSCLC patients were analyzed using a clinically validated 16-plex PCR-NGS assay (Signatera™, Natera, Inc.). Longitudinal plasma samples were tested post-curative-intent treatment. Results showed that patients with persistent ctDNA negativity had significantly improved recurrence-free survival (RFS). Notably, 100% of patients with extracranial metastases and 50% with brain metastases had ctDNA positivity prior to clinical recurrence, with median lead times of 7 and 10 months respectively. Patients with any ctDNA positivity post-treatment were 25 times more likely to relapse.<br /><br />These findings suggest that tumor-informed ctDNA testing has a high negative predictive value (96%) and can complement radiographic surveillance by potentially detecting recurrence earlier. However, the clinical utility of this approach requires confirmation through prospective studies with larger cohorts.<br /><br />In conclusion, tumor-informed ctDNA monitoring is a valuable tool for active surveillance in NSCLC, improving early detection of recurrence and potentially guiding management beyond conventional imaging techniques. Further research is necessary to fully establish its role in clinical practice.

Asset Subtitle

Daniel Rosas

Meta Tag

Speaker Daniel Rosas

Topic Pathology and Biomarkers

Keywords

personalized ctDNA testing

tumor-informed ctDNA

non-small cell lung cancer

NSCLC

circulating tumor DNA

molecular residual disease

recurrence monitoring

16-plex PCR-NGS assay

Signatera

early detection of recurrence