We use cookies to understand how you use our site and to improve your experience. This includes personalizing content and advertising. To learn more, click here. By continuing to use our site, you accept our use of cookies. Cookie Policy.

Features Partner Sites Information LinkXpress hp
Sign In
Advertise with Us
INTEGRA BIOSCIENCES AG

Download Mobile App




Liquid Biopsy Test Tracks Treatment-Based ctDNA Changes

By LabMedica International staff writers
Posted on 06 Oct 2021
Print article
Image: Circulating tumor DNA (ctDNA) is found in the bloodstream and refers to DNA that comes from cancerous cells and tumors. The LiquidHALLMARK assay, a liquid biopsy test, tracks treatment-based ctDNA changes (Photo courtesy of Jonathan Bailey, National Human Genome Research Institute)
Image: Circulating tumor DNA (ctDNA) is found in the bloodstream and refers to DNA that comes from cancerous cells and tumors. The LiquidHALLMARK assay, a liquid biopsy test, tracks treatment-based ctDNA changes (Photo courtesy of Jonathan Bailey, National Human Genome Research Institute)
Metastatic or unresectable disease is identified in approximately 20% of patients presenting with invasive urothelial cancer. In addition, up to 50% of patients will develop metastases following radical cystectomy for clinically localized disease.

Multiagent cisplatin-based chemotherapy is considered standard first-line treatment for these patients. Although urothelial cancer is considered a chemosensitive tumor, metastatic disease is associated with poor prognosis and short-term survival.

Medical Scientists collaborating with those at the Dana-Farber Cancer Institute (Boston, MA, USA) followed 45 participants with metastatic urothelial carcinoma, or mUC, 39 of who underwent immune checkpoint inhibitor, or ICI, therapy while six received cisplatin-based chemotherapy. The median age was 68 years, 79% of patients were male, and 97% had urothelial histology. The majority (82%) received single-agent ICI (PD1/L1 inhibitor). Median duration between pre and post samples was 6.2 months.

Investigators collected plasma samples before therapy and about six months afterwards, then correlated changes in circulating tumor DNA (ctDNA) with objective response using the LiquidHALLMARK assay (Lucence, Palo Alto, CA, USA). Paired pre and post samples underwent ctDNA evaluation with 7 to 30 ng of DNA using an 80-gene panel which employs an amplicon-based NGS assay, including fusions (Lucence, LiquidHALLMARK). The primary objective was to evaluate ctDNA alterations pre- and post-ICI, and to correlate with objective response.

The investigators reported that the most common variants pre- and post-ICI were in TP53 (54% and 49%), TERT (49% and 49%) and BRCA1/2 (36% and 33%). Nine patients were responding to ICI at time of post-ICI blood collection, with seven (78%) showing clearance of ≥1 ctDNA variants, most commonly in TP53, PI3KCA, and BRCA1/2. In 18/20 patients (90%) who were progressing at time of post-ICI collection had emergence of a new alteration, most commonly in BRCA1/2, PI3KCA, CCND2/RB, and TP53. BRCA1 and PIK3CA mutations emerged in only one and zero chemo patients. Patients who cleared TP53 alterations during ICI had a higher likelihood of response compared to those who did not (50% versus 17%).

Guru Sonpavde, MD, a Medical Oncologist and the principal investigator said, “This is somewhat impressive because in most ctDNA platforms, there is not such a high percentage of patients where you see ctDNA alterations.”

The authors concluded that ctDNA alterations were detected in 96% of pre/post-ICI samples overall. Clearance of TP53 alterations during ICI therapy was associated with response, while emergence of BRCA1/2 or PI3KCA variants appeared to be associated with resistance. The study was presented at the European Society for Medical Oncology Virtual Congress held September 16-21, 2021.

Related Links:
Dana-Farber Cancer Institute
Lucence


New
Gold Member
Thyroid Stimulating Hormone Assay
TSH EIA 96 Test
Antipsychotic TDM Assays
Saladax Antipsychotic Assays
New
Hepato Fibrosis Assays
Hepato Fibrosis Assays
New
Gold Member
ANA & ENA Screening Assays
ANA and ENA Assays

Print article

Channels

Clinical Chemistry

view channel
Image: The new saliva-based test for heart failure measures two biomarkers in about 15 minutes (Photo courtesy of Trey Pittman)

POC Saliva Testing Device Predicts Heart Failure in 15 Minutes

Heart failure is a serious condition where the heart muscle is unable to pump sufficient oxygen-rich blood throughout the body. It ranks as a major cause of death globally and is particularly fatal for... Read more

Molecular Diagnostics

view channel
Image: Genome sequencing technology has the potential to detect thousands of genetic disease (Photo courtesy of 123RF)

Gene Technology Outperforms Standard Newborn Screening Tests in Pioneering Study

Since its introduction in the 1960s, newborn screening has grown to encompass dozens of primarily genetic disorders. The standard approach to newborn screening involves detecting specific biomarkers in... Read more

Hematology

view channel
Image: QScout CBC will give a complete blood count in 2 minutes from fingerstick or venous blood (Photo courtesy of Ad Astra Diagnostics)

Next Gen CBC and Sepsis Diagnostic System Targets Faster, Earlier, Easier Results

Every hour is critical in protecting patients from infections, yet there are currently limited tools to assist in early diagnosis before patients reach a hospital. The complete blood count (CBC) is a common... Read more

Microbiology

view channel
Image: The InfectoSynovia test has the potential to revolutionize the diagnosis of periprosthetic joint infection (Photo courtesy of 123RF)

High-Accuracy Bedside Test to Diagnose Periprosthetic Joint Infection in Five Minutes

Periprosthetic joint infection (PJI) represents a significant global issue that is worsening as the number of joint replacements increases due to aging populations. In the United States alone, the anticipated... Read more
Copyright © 2000-2024 Globetech Media. All rights reserved.