A large number of patients with advanced lung cancer may soon be offered a blood test to decide the best treatment for them instead of getting a tumor sample for analysis. New BFAST test data presented at ESMO Congress 2019 have shown that the test can be used successfully to identify complex DNA mutations in the cells of patients with small cell lung cancer (NSCLC) suitable for the latest targeted drugs. The technique reveals small pieces of tumor DNA that are shed from cancer cells in the blood.
"One of the major recent changes in NSCLC treatment has been our ability to identify targeted genetic mutations that cause progression of the disease, but it is a great challenge to obtain a suitable tumor sample for analysis. We have shown that liquid biopsy can be used to detect "A complex type of driver mutation, called ALK, in NSFL patients. These have then responded at least to targeted therapy as in previous studies using conventional biopsy techniques," study author Dr Chi explained. Rich Gadel, Rogel Cancer Center, University of Michigan, USA.
In the BFAST analysis, over 2,000 patients with untreated NSCLC had blood tests using state-of-the-art technology to check for multiple genetic mutations in the driver. It was found that approximately 1 in 20 has tumor DNA that shows rearrangement in the ALK gene. In patients treated with alectinib, treatment with cancer directed at ALK mutation, over three quarters showed no signs of progression in the following 12 months.
"Liquid biopsy identified a similar percentage of patients with ALK mutations to those typically seen with a traditional biopsy and the results with alectinib compare well with those seen in a key study of this treatment," said Gadzel.
Commenting on the results of the study, prof. Alberto Bardelli, Department of Oncology, University of Turin, Italy, said: "The ALC gene rearrangement described in the BFAST study is usually difficult to detect, so it is important to prove that it can be detected in the blood and used. to guide ALK inhibitor treatment, which was then shown to be effective in patients with this mutation. "
"It is encouraging to see that the increasing number of lung cancer patients may benefit from liquid biopsy to identify their disease mutation rather than tissue samples. Currently the technology is quite expensive but as it is becoming more widely used , the price is likely to come down, so testing becomes more accessible and available in everyday practice, "he added.
In the phase II / III BFAST trial, 2,219 patients treated with NBCLs who were not treated with phase IIIB / IV had a sequential next-generation blood-based (NGS) sequence of active genetic modifications, and the results were obtained in 2,188 patients. Overall, 119 patients (5.4%) had ALK + disease and 87 of them were enrolled to receive alectinib. Median follow-up was 12.6 months. Confirmed Real Response Rate (SDR) reported by investigators is 87.4% (95% SE 78.5-93.5) and 12-month response duration (DOR) is 75.9% (95% SE 63.6) -88.2). Medium progression-free survival (PFS) was not achieved, but the 12-month PFS reported by investigators was 78.4% (95% CI 69.1-87.7). The safety data were in accordance with the known safety profile of alectinib.
Liquid biopsy has a prognostic role in colorectal cancer and the potential for leading therapy
LBA81_PR & # 39; Trial trial of Phase II / III first blood test (BFAST) in patients with treatment-na Nve NSCLC: preliminary results of ALK + cohort & # 39; will present Jirish Gadzel during a paper session on Monday, September 30, 2019, 08: 30-10: 00 CEST in the Auditorium in Madrid (Hall 2). Annals of Oncology, Volume 30, Supplement 5, October 2019
Blood test may replace invasive biopsy for more patients with lung cancer (2019, 30.09)
Retrieved September 30, 2019
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