Plasma ctDNA Genotyping Can Accelerate Time to Treatment for NSCLC

FRIDAY, July 28, 2023 (HealthDay News) -- For patients with suspected advanced non-small cell lung cancer (NSCLC), plasma circulating tumor (ct)DNA genotyping before tissue diagnosis is associated with accelerated time to treatment, according to a study published online July 25 in JAMA Network Open.

Miguel García-Pardo, M.D., from the Princess Margaret Cancer Centre at the University Health Network in Toronto, and colleagues conducted a single-group nonrandomized clinical trial among 150 patients. Eligible patients were referred for investigation and diagnosis of lung cancer if they had radiologic evidence of advanced lung cancer prior to a tissue diagnosis. Before lung cancer diagnosis, patients underwent plasma ctDNA testing with a next-generation sequencing (NGS) assay. The primary end point was time from referral to treatment initiation among patients with advanced nonsquamous NSCLC using ctDNA testing before diagnosis (Accelerating Lung Cancer Diagnosis Through Liquid Biopsy [ACCELERATE] cohort) compared with a reference cohort using standard tissue genotyping after tissue diagnosis.

Ninety of the 150 patients enrolled had advanced nonsquamous NSCLC. The researchers found that the median time to treatment was 39 and 62 days for the ACCELERATE and reference cohorts, respectively. From sample collection to genotyping results, the median turnaround time was seven days for plasma and 23 days for tissue NGS among the ACCELERATE cohort. Of the 90 patients with nonsquamous NSCLC, 23 and 12 percent started targeted therapy before tissue NGS results were available and had actionable alterations identified only through plasma testing, respectively.

"The effect of this approach on clinically meaningful outcomes, such as quality of life, survival, and cost-effectiveness, still needs to be demonstrated," the authors write.

Several authors disclosed ties to the pharmaceutical industry.

Abstract/Full Text