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Confirmation of Recurrent Lung Cancer Following Resection Using Liquid Biopsy, a Proof-of-Concept Real-World Study.

Julia R Naso1,2, Stephen Yip1,2,3,4, Curtis Hughesman4

  • 1Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC V5Z 4E6, Canada.

Current Oncology (Toronto, Ont.)
|July 26, 2024
PubMed
Summary

Timely confirmation of non-small cell lung cancer (NSCLC) recurrence is crucial. Circulating tumor DNA (ctDNA) detected via amplicon sequencing shows promise for identifying NSCLC recurrence, potentially avoiding invasive biopsies.

Keywords:
biomarkerlung cancernext-generation sequencingtargeted therapy

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Area of Science:

  • Oncology
  • Molecular Diagnostics
  • Genomics

Background:

  • Accurate and timely confirmation of non-small cell lung cancer (NSCLC) recurrence is essential for appropriate patient management after curative-intent surgery.
  • Current surveillance methods rely on imaging, but molecular confirmation is increasingly important.

Purpose of the Study:

  • To assess the association between circulating tumor DNA (ctDNA) detected by amplicon sequencing and CT-imaged evidence of NSCLC recurrence.
  • To explore the potential of ctDNA as a non-invasive tool for confirming NSCLC recurrence.

Main Methods:

  • A prospective cohort study involving early-stage NSCLC patients undergoing curative-intent resection.
  • Post-operative surveillance included serial liquid biopsies and chest CT imaging.
  • Tumor tissue and plasma cell-free DNA were analyzed using amplicon panel next-generation sequencing for tumor-informed ctDNA detection.

Main Results:

  • Of 78 NSCLC patients, 65 had detectable alterations in tumor DNA.
  • Among 29 patients with detectable tumor DNA alterations who underwent liquid biopsy, four showed evidence of recurrence on imaging.
  • Two of these four patients had biopsy-confirmed recurrence and detectable ctDNA at 12-month follow-up.

Conclusions:

  • Amplicon sequencing of plasma ctDNA can provide molecular confirmation of NSCLC recurrence in patients with imaging-based suspicion.
  • ctDNA confirmation may help avoid invasive tissue diagnosis in suspected recurrence cases.
  • Further research on ctDNA technologies is needed to refine post-operative lung cancer surveillance guidelines.