scholarly journals Plasma ctDNA Response Is an Early Marker of Treatment Effect in Advanced NSCLC

2021 ◽  
pp. 393-402
Author(s):  
Michael L. Cheng ◽  
Christie J. Lau ◽  
Marina S. D. Milan ◽  
Julianna G. Supplee ◽  
Jonathan W. Riess ◽  
...  
Keyword(s):  
Treatment Effect ◽  
Advanced Nsclc ◽  
Response Assessment ◽  
Early Response ◽  
Circulating Tumor Dna ◽  
Driver Mutations ◽  
Treatment Start ◽  
Early Response Assessment ◽  
Ctdna Analysis ◽  
Egfr Mutant

PURPOSE Plasma circulating tumor DNA (ctDNA) analysis is routine for genotyping of advanced non–small-cell lung cancer (NSCLC); however, early response assessment using plasma ctDNA has yet to be well characterized. MATERIALS AND METHODS Patients with advanced EGFR-mutant NSCLC across three phase I NCI osimertinib combination trials were analyzed in this study, and an institutional cohort of patients with KRAS-, EGFR-, and BRAF-mutant advanced NSCLC receiving systemic treatment was used for validation. Plasma was collected before treatment initiation and serially before each cycle of therapy, and key driver mutations in ctDNA were characterized by droplet digital polymerase chain reaction. Timing of plasma versus imaging response was compared in a separate cohort of patients with EGFR-mutant NSCLC treated with osimertinib. Across cohorts, we also studied ctDNA variability before treatment start. RESULTS In the NCI cohort, 14/16 (87.5%) patients exhibited ≥ 90% decrease in mutation abundance by the first on-treatment timepoint (20-28 days from treatment start) with minimal subsequent change. Similarly, 47/56 (83.9%) patients with any decrease in the institutional cohort demonstrated ≥ 90% decrease in mutation abundance by the first follow-up draw (7-30 days from treatment start). All 16 patients in the imaging cohort with radiographic partial response showed best plasma response within one cycle, preceding best radiographic response by a median of 24 weeks (range: 3-147 weeks). Variability in ctDNA levels before treatment start was observed. CONCLUSION Plasma ctDNA response is an early phenomenon, with the majority of change detectable within the first cycle of therapy. These kinetics may offer an opportunity for early insight into treatment effect before standard imaging timepoints.

scholarly journals Circulating tumor DNA in early response assessment and monitoring of advanced colorectal cancer treated with a multi-kinase inhibitor

Oncotarget ◽  
2018 ◽  
Vol 9 (25) ◽  
pp. 17756-17769 ◽  
Author(s):  
Caroline Vandeputte ◽  
Pashalina Kehagias ◽  
Hakim El Housni ◽  
Lieveke Ameye ◽  
Jean-François Laes ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Advanced Colorectal Cancer ◽  
Kinase Inhibitor ◽  
Response Assessment ◽  
Early Response ◽  
Circulating Tumor Dna ◽  
Assessment And Monitoring ◽  
Early Response Assessment ◽  
Tumor Dna

scholarly journals Magnetic Resonance Imaging during Proton Therapy Irradiation Allows for the Early Response Assessment of Pediatric Chordoma

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 1117
Author(s):  
Sabina Vennarini ◽  
Dante Amelio ◽  
Stefano Lorentini ◽  
Giovanna Stefania Colafati ◽  
Antonella Cacchione ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Proton Therapy ◽  
Treatment Plan ◽  
Surgical Excision ◽  
Response Assessment ◽  
Early Response ◽  
High Dose ◽  
Resonance Imaging ◽  
Early Response Assessment

Chordoma in pediatric patients is very rare. Proton therapy has become a gold standard in the treatment of these neoplasms, as high dose escalation can be achieved regarding the target while maximizing the sparing of the healthy tissues near the tumor. The aim of the work was to assess the evolution of morphological sequences during treatment using T1/T2-weighted magnetic resonance imaging (MRI) for the early response assessment of a classic chordoma of the skull base in a pediatric patient who had undergone surgical excision. Our results demonstrated a significant quantitative reduction in the residual nodule component adhered to the medullary bulb junction, with an almost complete recovery of normal anatomy at the end of the irradiation treatment. This was mainly shown in the T2-weighted MRI. On the other hand, the classic component of the lesion was predominantly present and located around the tooth of the axis. The occipital condyles were morphologically and dimensionally stable for the entire irradiation period. In conclusion, the application of this type of monitoring methodology, which is unusual during the administration of a proton treatment for chordoma, highlighted the unexpected early response of the disease. At the same time, it allowed the continuous assessment of the reliability of the treatment plan.

scholarly journals Early response assessment and prediction of overall survival after peptide receptor radionuclide therapy

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Daphne M. V. Huizing ◽  
Else A. Aalbersberg ◽  
Michelle W. J. Versleijen ◽  
Margot E. T. Tesselaar ◽  
Iris Walraven ◽  
...  
Keyword(s):  
Overall Survival ◽  
Radionuclide Therapy ◽  
Peptide Receptor Radionuclide Therapy ◽  
Response Assessment ◽  
Early Response ◽  
Peptide Receptor ◽  
Early Response Assessment

Early response assessment of re-ossification after palliative conventional radiotherapy for vertebral bone metastases

2019 ◽  
Vol 24 (2) ◽  
pp. 332-336
Author(s):  
Eiji Nakata ◽  
Shinsuke Sugihara ◽  
Masaaki Kataoka ◽  
Natsumi Yamashita ◽  
Takayuki Furumatsu ◽  
...  
Keyword(s):  
Bone Metastases ◽  
Response Assessment ◽  
Early Response ◽  
Conventional Radiotherapy ◽  
Vertebral Bone ◽  
Early Response Assessment

Risk-Adapted Treatment of Advanced Hodgkin Lymphoma With PET-CT

2016 ◽  
pp. e376-e385
Author(s):  
Ryan C. Lynch ◽  
Ranjana H. Advani
Keyword(s):  
Hodgkin Lymphoma ◽  
Adaptive Design ◽  
Response Assessment ◽  
Early Response ◽  
Clinical Criteria ◽  
Interim Pet ◽  
Early Results ◽  
Pet Ct ◽  
Risk Patients ◽  
Early Response Assessment

Although patients with advanced-stage classic Hodgkin lymphoma have excellent outcomes with contemporary therapy, the outcomes of patients with refractory disease is suboptimal. Identification of these high-risk patients at diagnosis is challenging as the differences in outcomes using clinical criteria are less marked using current modern therapy. Data suggest that an interim PET-CT may be a powerful tool in risk-stratifying patients. Retrospective studies show that a negative interim PET-CT after two to four cycles of ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine) is predictive of favorable outcome independent of IPS score. Currently, there are several ongoing trials that aim to determine whether early-response assessment can be used to select patients who might benefit from modifications of subsequent therapy, either by intensifying or abbreviating regimens and/or omitting radiotherapy with promising early results. Longer follow-up is required to assess whether this strategy impacts overall survival (OS). Herein, we review the results of recent trials using interim PET-CT-based adaptive design in the treatment of advanced HL.

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