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Clin Cancer Res. 2016 Nov 15;22(22):5497-5505. doi: 10.1158/1078-0432.CCR-16-0318. Epub 2016 May 16.

Use of Liquid Biopsies in Clinical Oncology: Pilot Experience in 168 Patients.

Author information

1
Center for Personalized Cancer Therapy and Division of Hematology and Oncology, UCSD Moores Cancer Center, La Jolla, California. mschwaederle@ucsd.edu.
2
Center for Personalized Cancer Therapy and Division of Hematology and Oncology, UCSD Moores Cancer Center, La Jolla, California.
3
Division of Biomedical Informatics, Department of Medicine, UC San Diego School of Medicine, La Jolla, California.

Abstract

PURPOSE:

There is a growing interest in using circulating tumor DNA (ctDNA) testing in patients with cancer.

EXPERIMENTAL DESIGN:

A total of 168 patients with diverse cancers were analyzed. Patients had digital next-generation sequencing (54 cancer-related gene panel including amplifications in ERBB2, EGFR, and MET) performed on their plasma. Type of genomic alterations, potential actionability, concordance with tissue testing, and patient outcome were examined.

RESULTS:

Fifty-eight percent of patients (98/168) had ≥1 ctDNA alteration(s). Of the 98 patients with alterations, 71.4% had ≥ 1 alteration potentially actionable by an FDA-approved drug. The median time interval between the tissue biopsy and the blood draw was 2.7 months for patients with ≥ 1 alteration in common compared with 14.4 months (P = 0.006) for the patients in whom no common alterations were identified in the tissue and plasma. Overall concordance rates for tissue and ctDNA were 70.3% for TP53 and EGFR, 88.1% for PIK3CA, and 93.1% for ERBB2 alterations. There was a significant correlation between the cases with ≥ 1 alteration with ctDNA ≥ 5% and shorter survival (median = 4.03 months vs. not reached at median follow-up of 6.1 months; P < 0.001). Finally, 5 of the 12 evaluable patients (42%) matched to a treatment targeting an alteration(s) detected in their ctDNA test achieved stable disease ≥ 6 months/partial remission compared with 2 of 28 patients (7.1%) for the unmatched patients, P = 0.02.

CONCLUSIONS:

Our initial study demonstrates that ctDNA tests provide information complementary to that in tissue biopsies and may be useful in determining prognosis and treatment. Clin Cancer Res; 22(22); 5497-505. ©2016 AACR.

PMID:
27185373
DOI:
10.1158/1078-0432.CCR-16-0318
[Indexed for MEDLINE]
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