New test could use tumor DNA to predict lung cancer outcome

Scientists from the Francis Crick Institute, UCL, UCLH and Personalis have found in a study funded by Cancer Research UK that a test that detects circulating tumor DNA can predict lung cancer outcome.

Circulating tumor DNA (ctDNA) is DNA fragments released into the blood by tumors. Although it is known to be important for disease prognosis, it can be difficult to measure accurately.

In a study published today, natural medicineCrick and UCL scientists worked with Personalis to test a platform called NeXT Personal, which can detect very small amounts (one part per million) of ctDNA. This is based on the Click team's discovery of a signal in the blood that detects cancer cells that may indicate a chance of recurrence after treatment.

They applied this platform to plasma samples from 171 early-stage lung cancer patients in the TRACERx cohort and found that those with lower preoperative ctDNA levels were less likely to relapse and had improved overall survival than those with higher levels. It turned out that ctDNA.

The test's higher sensitivity meant it could detect smaller amounts of ctDNA, preventing people with low amounts of ctDNA from being mistakenly labeled as ctDNA negative.

Early stage lung cancer is usually treated with surgery to remove the tumor and chemotherapy or chemotherapy. immunotherapyDepending on the stage of the tumor, we aim to achieve the highest chance of cure.

The test is then evaluated on samples taken from the earliest patients who underwent surgery. stages of lung cancerto assess whether the presence of ctDNA in postoperative blood can be used to infer future recurrence risk. This could allow doctors to provide additional treatment after surgery, increasing the patient's chances of recovery..

James Black, a postdoctoral fellow at the Francis Crick Institute and UCL's CRUK Lung Cancer Center of Excellence, said: 'The presence or absence of tumor DNA in the blood has been shown to be a strong predictor of prognosis, especially when compared to ctDNA testing. The use of ultra-sensitive platforms will allow clinicians to make more informed decisions about treatment, and further studies to validate these tests will be on the regular clinical agenda. may be helpful. Use.

Charles Swanton, Deputy Clinical Director and Director of the Institute of Cancer Evolution and Genome Instability at Crick, Medical Oncologist at University College London Hospital, Professor of Personalized Cancer Medicine at the UCL Institute of Cancer Research, and Principal Investigator of TRACERx , the study's senior author, said: “Lung cancer is one of the most common cancers in the UK, but it has high recurrence rates and is difficult to treat. Understanding who would benefit from more aggressive treatment This is extremely important. For stage 1 patients, who are often diagnosed as high risk on CT screening, one way to do this is to use highly sensitive ctDNA testing, which maximizes clinical benefit and We hope to minimize unnecessary treatments for patients.”

said Richard Chen, chief medical officer and executive vice president of research and development at Personalis. “We designed NeXT Personal to detect residual or recurrent cancer at an early stage, and this study demonstrates the clinical importance of ultrasensitive detection at an early stage.”For lung cancer However, sensitive tests like NeXT Personal offer patients the possibility of early detection and early treatment, and a negative test could potentially avoid unnecessary treatment in the future. . ”

TRACERx is our flagship lung cancer research study that tracks lung cancer progression over time. As a difficult-to-treat cancer, the more you understand about its progression, the better equipped you will be to beat it.

The types of tests used in NeXT Personal will help us move into the era of personalized medicine, allowing clinicians to accurately classify patients into groups based on the impact of their disease, so they can give the right treatment to the right people. We will make it available to you. This test can help improve people's lives by helping clinicians focus their efforts on people whose disease is likely to return after treatment and avoid difficult treatments that are not needed when the risk of disease is low. Helps improve quality and survival rates.

Although more research is needed, this study brings us one step closer to tailoring treatments to patients. The next chapter of TRACERx, TRACERx EVO, is currently recruiting study participants and will explore the biology of lung cancer in greater depth. ”

Marianne Baker, Cancer Research UK Research Information Manager

This research was supported by the National Institute for Health and Care Excellence UCLH Biomedical Research Center.