Applications of Circulating Tumor DNA in Immune Checkpoint Inhibition: Emerging Roles and Future Perspectives

Area of Science:

• Oncology
• Immunotherapy
• Molecular Diagnostics

Background:

• Immune checkpoint inhibitors (ICIs), particularly anti-PD-1/PD-L1 antibodies, have advanced lung cancer treatment, especially for non-oncogene-driven tumors.
• Patient response to ICIs is variable, necessitating predictive biomarkers to identify optimal candidates.
• Noninvasive biomarkers are crucial for predicting response, monitoring resistance, and tracking tumor evolution during ICI therapy.

Purpose of the Study:

• To review the application of circulating tumor DNA (ctDNA) in plasma as a biomarker for immunotherapy in lung cancer.
• To evaluate the potential of pre- and on-treatment ctDNA features for predicting ICI response.
• To explore the clinical value of integrating liquid biomarkers for optimizing patient management and monitoring treatment resistance.

Main Methods:

• Review of existing literature on ctDNA applications in lung cancer immunotherapy.
• Analysis of pre- and on-treatment ctDNA features as predictive biomarkers.
• Discussion of multiparameter analysis for integrating liquid biomarkers.

Main Results:

• ctDNA holds significant potential as a minimally invasive biomarker for predicting ICI response in lung cancer.
• Pre- and on-treatment ctDNA analysis can provide dynamic insights into treatment efficacy and resistance.
• Integration of ctDNA with other biomarkers may enhance patient stratification and treatment monitoring.

Conclusions:

• ctDNA is a promising liquid biomarker for optimizing the use of ICIs in lung cancer.
• Further research and clinical validation are required to overcome challenges in ctDNA's translation to routine practice.
• ctDNA analysis can aid in monitoring treatment resistance and guiding therapeutic decisions in lung cancer patients receiving immunotherapy.