Post-Treatment Blood Test Could Inform Future Cancer Therapy Decisions

In the ongoing advancement of personalized medicine, a new study has provided evidence supporting the use of a tool that detects cancer-derived molecules in the blood of lung cancer patients years after their treatment. This tool is a form of molecular residual disease (MRD) detector, which helps monitor the cancer status of patients after they have completed their primary treatment. Researchers suggest that this tool could play a crucial role in guiding clinical decisions, including determining whether to restart or intensify treatment.

The study, conducted by researchers at Yale School of Medicine (New Haven, CT, USA), and published in Nature Medicine, focused on patients from the ADAURA clinical trial. This trial investigated the targeted therapy osimertinib for patients with non-small cell lung cancer (NSCLC) carrying epidermal growth factor (EGFR)-activated mutations. The findings from the ADAURA trial demonstrated a significant benefit in disease-free survival for patients treated with osimertinib compared to those given a placebo, establishing it as the recommended treatment for patients up to three years after surgery. If MRD proves to be clinically viable, it could enhance outcomes by identifying high-risk patients who might benefit from intensified or restarted treatment. Conversely, MRD could also help pinpoint patients at low risk for recurrence, potentially sparing them from unnecessary further treatments and the associated toxicities of drugs.

“MRD detection is the future — allowing us to monitor patients in real-time,” said the study’s first author, Dr. Roy Herbst, deputy director of Yale Cancer Center and chief of medical oncology and hematology at Yale School of Medicine. “The data is strong and we're excited that our approach can now be incorporated into future studies.”

“We know patients benefited from osimertinib in the ADAURA trial, but we want to know if they are cured or whether their cancer will come back,” added Herbst, who is also the assistant dean for translational research at Yale School of Medicine. “MRD detection is a more personalized approach for patients with EGFR mutations in the adjuvant setting [after the primary treatment has completed], and now we're understanding at what point patients start to benefit and how we can more precisely target their therapy.”

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