FP07.11 Circulating Tumor DNA (ctDNA) Clearance as a Biomarker in Patients With Locally Advanced NSCLC Following Chemoradiation

2021 ◽  
Vol 16 (3) ◽  
pp. S208
Author(s):  
B. Knapp ◽  
L. Mezquita ◽  
S. Devarakonda ◽  
M. Aldea ◽  
S. Waqar ◽  
...  
Keyword(s):  
Advanced Nsclc ◽  
Locally Advanced ◽  
Circulating Tumor Dna ◽  
Locally Advanced Nsclc ◽  
Tumor Dna

scholarly journals Real-world prospective analysis of treatment patterns in durvalumab maintenance after chemoradiotherapy in unresectable, locally advanced NSCLC patients

2021 ◽  
Author(s):  
Julian Taugner ◽  
Lukas Käsmann ◽  
Chukwuka Eze ◽  
Alexander Rühle ◽  
Amanda Tufman ◽  
...  
Keyword(s):  
Prospective Study ◽  
Real World ◽  
Maintenance Treatment ◽  
Progressive Disease ◽  
Advanced Nsclc ◽  
Locally Advanced ◽  
Contrast Enhanced Ct ◽  
Unresectable Stage ◽  
Locally Advanced Nsclc

SummaryThe aim of this prospective study is to evaluate the clinical use and real-world efficacy of durvalumab maintenance treatment after chemoradiotherapy (CRT) in unresectable stage, locally advanced non-small cell lung cancer (NSCLC). All consecutive patients with unresectable, locally advanced NSCLC and PD-L1 expression (≥1%) treated after October 2018 were included. Regular follow up, including physical examination, PET/CT and/or contrast-enhanced CT-Thorax/Abdomen were performed every three months after CRT. Descriptive treatment pattern analyses, including reasons of discontinuation and salvage treatment, were undertaken. Statistics were calculated from the last day of thoracic irradiation (TRT). Twenty-six patients were included. Median follow up achieved 20.6 months (range: 1.9–30.6). Durvalumab was initiated after a median of 25 (range: 13–103) days after completion of CRT. In median 14 (range: 2–24) cycles of durvalumab were applied within 6.4 (range 1–12.7) months. Six patients (23%) are still in treatment and seven (27%) have completed treatment with 24 cycles. Maintenance treatment was discontinued in 13 (50%) patients: 4 (15%) patients developed grade 3 pneumonitis according to CTCAE v5 after a median of 3.9 (range: 0.5–11.6) months and 7 (range: 2–17) cycles of durvalumab. Four (15%) patients developed grade 2 skin toxicity. One (4%) patient has discontinued treatment due to incompliance. Six and 12- month progression-free survival (PFS) rates were 82% and 62%, median PFS was not reached. No case of hyperprogression was documented. Eight (31%) patients have relapsed during maintenance treatment after a median of 4.8 (range: 2.2–11.3) months and 11 (range: 6–17) durvalumab cycles. Two patients (9%) developed a local-regional recurrence after 14 and 17 cycles of durvalumab. Extracranial distant metastases and brain metastases as first site of failure were detected in 4 (15%) and 2 (8%) patients, respectively. Three (13%) patients presented with symptomatic relapse. Our prospective study confirmed a favourable safety profile of durvalumab maintenance treatment after completion of CRT in unresectable stage, locally advanced NSCLC in a real-world setting. In a median follow-up time of 20.6 months, durvalumab was discontinued in 27% of all patients due to progressive disease. All patients with progressive disease were eligible for second-line treatment.

PD-0413: The role of different chemotherapy protocols for concurrent CRT in locally advanced NSCLC

2020 ◽  
Vol 152 ◽  
pp. S223-S224
Author(s):  
E. Gkika ◽  
S. Tanja ◽  
K. Stephanie ◽  
A. Schaefer-Schuler ◽  
M. Mix ◽  
...  
Keyword(s):  
Advanced Nsclc ◽  
Locally Advanced ◽  
Locally Advanced Nsclc

IMRT and 3D conformal radiotherapy with or without elective nodal irradiation in locally advanced NSCLC

2015 ◽  
Vol 192 (2) ◽  
pp. 75-82 ◽  
Author(s):  
Jochen Fleckenstein ◽  
Katharina Kremp ◽  
Stephanie Kremp ◽  
Jan Palm ◽  
Christian Rübe
Keyword(s):  
Advanced Nsclc ◽  
Locally Advanced ◽  
Conformal Radiotherapy ◽  
Elective Nodal Irradiation ◽  
3D Conformal Radiotherapy ◽  
Locally Advanced Nsclc

scholarly journals OC-0301: Target position uncertainty during visually guided breathhold radiotherapy in locally advanced NSCLC

2017 ◽  
Vol 123 ◽  
pp. S155-S156
Author(s):  
J. Scherman Rydhög ◽  
S. Riisgaard Mortensen ◽  
M. Josipovic ◽  
R. Irming Jølck ◽  
T. Andresen ◽  
...  
Keyword(s):  
Advanced Nsclc ◽  
Locally Advanced ◽  
Target Position ◽  
Visually Guided ◽  
Position Uncertainty ◽  
Locally Advanced Nsclc

Residual of circulating tumor DNA (ctDNA) indicated therapeutic efficacy of sintilimab plus docetaxel in patients with previously treated advanced non-small cell lung cancer (NSCLC).

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e21207-e21207
Author(s):  
Zhehai Wang ◽  
Xiao Han ◽  
Jun Guo ◽  
Ming Jia ◽  
Changbin Zhu ◽  
...  
Keyword(s):  
Disease Progression ◽  
Advanced Nsclc ◽  
Objective Response ◽  
Synergetic Effect ◽  
Circulating Tumor Dna ◽  
First Line ◽  
Long Term Outcome ◽  
Significant Difference ◽  
Previously Treated ◽  
Tumor Dna

e21207 Background: The synergetic effect of ICIs plus chemotherapy has been demonstrated in first line setting for patients with advanced NSCLC. As previously reported, sintilimab plus docetaxel in advanced Chinese NSCLC pts who had failed first-line chemotherapy showed encouraging efficacy and tolerable safety profile. This exploratory study aims to investigate putative biomarker(s) predicting therapeutic response and long-term outcome for eligible patients. Methods: Advanced NSCLC pts who had failed standard platinum doublet without receiving any ICIs before would receive docetaxel (75mg/m2, day 1) plus sintilimab (200mg, day 3) every 3 weeks for 4-6 cycles followed by sintilimab maintenance until disease progression, unacceptable toxicity, or up to 2 years. Thirty-nine eligible patients received comprehensive genomic profiling of circulating tumor DNA (ctDNA) via a 448-gene panel before treatment. ctDNA from twenty-three patients were dynamically assessed after two courses (at 6th week). Eventually, 22 patients were enrolled into analysis, one patient was lost. White blood cells were used to filter germline variants from ctDNA sequencing data. Results: Of 22 patients with paired ctDNA profiling results at 6th week, 11 patients (50%) were defined as ctDNA residual due to presence of ≥2 somatic variants; Another 11 patients (50%) who had ≤1 somatic variant were defined as non-ctDNA residual. Significant difference of best objective response rate (ORR) (63.64% vs 0%, P=0.0039, two-sided Fisher’s Exact Testing for non-ctDNA residual vs ctDNA residual patients) was observed between these two populations. And numerically higher disease control rate (DCR) was seen in non-ctDNA residual patients (100% vs 63.64%, non-ctDNA residual vs ctDNA residual). Further, patients with ctDNA residual after 2 courses of sintilimab plus docetaxel (at 6th week) displayed higher risk of disease progression [Hazard Ratio (95%CI), 9.91(2.09-46.97), P=0.0038] and inferior prognosis (median PFS, ctDNA residual vs non-ctDNA residual, 3.0 months vs NR, P=0.0007). In addition, mutations of EGFR and LRP1B were enriched in ctDNA residual group. Especially, LRP1B gene mutations associated with shorter PFS period, which should be further investigated. Conclusions: Residual of ctDNA at 6th week was able to indicate inferior response to sintilimab plus docetaxel in patients with previously treated advanced NSCLC. Further validation of ctDNA residual as a robust predictive biomarker is warranted. [Table: see text]

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