Presented by: Joel W Neal, MD. PhD
Covered by: Ivy Riano, M.D., Research Chief Fellow, Hematology and Oncology Unit, Dartmouth Cancer Center, Lebanon, NH.
Dr. Joel Neal, Associate Professor of Medicine at Stanford Cancer Institute, provides an update of precision oncology methods in lung cancer focused on circulating tumor DNA (ctDNA). Traditionally, lung cancer treatment was viewed as a ‘one-size-fits-all’ approach. However, it is becoming evident that non-small cell lung cancer (NSCLC) is a molecularly complex amalgam of diseases resulting in vastly different outcomes [1]. As a result, treatment paradigms have shifted towards increasingly personalized approaches, giving rise to ctDNA as a tool for making informed treatment decisions.
Plasma-derived ctDNA is the most extensively studied analyte to provide sampling of the molecular content within tumor cells [2]. As such, the assessment of oncogenic driver alterations by ctDNA has become an accepted companion diagnostic for advanced NSCLC. During this session, Dr. Neal provides a growing list of ctDNA applications in the clinical management of NSCLC such as non-invasive diagnosis, monitoring, and detection of recurrence in advanced NSCLC [3-5].
Moreover, Dr. Neal highlights that the detection of minimal residual disease (MRD) by ctDNA for patients with NSCLC after curative-intent treatment may serve as a prognostic and potentially predictive biomarker for recurrence and response to therapy [6]. Importantly, Dr. Neal shares some preliminary insights about the Adjuvant ctDNA-Adapted Personalized Treatment in Early-Stage NSCLC (ADAPT-E) trial. The session concludes by emphasizing that future opportunities include improvement of ctDNA sensitivity and looking at other molecules altered by tumors (ctRNA, proteins, metabolites).
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- Chaudhuri et al. Cancer Discovery 2017.
