Real-World Clinical Outcomes after Genomic Profiling of Circulating Tumor DNA in Patients with Previously Treated Advanced Non-Small Cell Lung Cancer
Comprehensive genomic profiling for advanced non-small cell lung cancer (NSCLC) can identify patients for molecularly targeted therapies that improve clinical outcomes. We analyzed data from 3084 patients (median age 65 years, 72.9% with adenocarcinoma) with advanced NSCLC registered in a real-world...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-07-01
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| Series: | Current Oncology |
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| Online Access: | https://www.mdpi.com/1718-7729/29/7/382 |
| _version_ | 1797433665621327872 |
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| author | Steven Olsen Jiemin Liao Hidetoshi Hayashi |
| author_facet | Steven Olsen Jiemin Liao Hidetoshi Hayashi |
| author_sort | Steven Olsen |
| collection | DOAJ |
| description | Comprehensive genomic profiling for advanced non-small cell lung cancer (NSCLC) can identify patients for molecularly targeted therapies that improve clinical outcomes. We analyzed data from 3084 patients (median age 65 years, 72.9% with adenocarcinoma) with advanced NSCLC registered in a real-world healthcare claims database (GuardantINFORM<sup>TM</sup>, Guardant Health) who underwent next-generation sequencing (NGS)-based circulating tumor DNA (ctDNA) testing (Guardant360<sup>®</sup>, Guardant Health) after first-line therapy (28.0% with agents targeted against genomic alterations). ctDNA was detected in 2771 samples (89.9%), of which 41.9% harbored actionable alterations, most commonly <i>EGFR</i> (epidermal growth factor receptor) mutations (29.7%). Actionable alterations were detected in 26.7% of patients (534/2001) previously treated with non-targeted agents. Emerging potentially targetable mutations were found in 40.1% (309/770) of patients previously treated with targeted therapies. Among patients with qualifying alterations detected by ctDNA testing, the time to treatment discontinuation (median 8.8 vs. 4.2 months; hazard ratio 1.97, <i>p</i> < 0.001) and overall survival (median 36.1 vs. 16.6 months; hazard ratio 2.08, <i>p</i> < 0.001) were longer for those who received matched second-line therapy versus unmatched second-line therapy. In real-world practice, results of a blood-based NGS assay prior to second-line treatment inform therapeutic decisions that can improve clinical outcomes for patients with advanced NSCLC. |
| first_indexed | 2024-03-09T10:20:13Z |
| format | Article |
| id | doaj.art-57f0e3573e1b407598b36a74eeb87fdd |
| institution | Directory Open Access Journal |
| issn | 1198-0052 1718-7729 |
| language | English |
| last_indexed | 2024-03-09T10:20:13Z |
| publishDate | 2022-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Current Oncology |
| spelling | doaj.art-57f0e3573e1b407598b36a74eeb87fdd2023-12-01T22:02:53ZengMDPI AGCurrent Oncology1198-00521718-77292022-07-012974811482610.3390/curroncol29070382Real-World Clinical Outcomes after Genomic Profiling of Circulating Tumor DNA in Patients with Previously Treated Advanced Non-Small Cell Lung CancerSteven Olsen0Jiemin Liao1Hidetoshi Hayashi2Department of Medical and Clinical Affairs, Guardant Health Japan Corp., Minato-ku, Tokyo 105-7590, JapanDepartment of Outcomes and Evidence, Guardant Health Inc., Redwood City, CA 94063, USADepartment of Medicine, Kindai University, Osaka-Sayama, Osaka 589-8511, JapanComprehensive genomic profiling for advanced non-small cell lung cancer (NSCLC) can identify patients for molecularly targeted therapies that improve clinical outcomes. We analyzed data from 3084 patients (median age 65 years, 72.9% with adenocarcinoma) with advanced NSCLC registered in a real-world healthcare claims database (GuardantINFORM<sup>TM</sup>, Guardant Health) who underwent next-generation sequencing (NGS)-based circulating tumor DNA (ctDNA) testing (Guardant360<sup>®</sup>, Guardant Health) after first-line therapy (28.0% with agents targeted against genomic alterations). ctDNA was detected in 2771 samples (89.9%), of which 41.9% harbored actionable alterations, most commonly <i>EGFR</i> (epidermal growth factor receptor) mutations (29.7%). Actionable alterations were detected in 26.7% of patients (534/2001) previously treated with non-targeted agents. Emerging potentially targetable mutations were found in 40.1% (309/770) of patients previously treated with targeted therapies. Among patients with qualifying alterations detected by ctDNA testing, the time to treatment discontinuation (median 8.8 vs. 4.2 months; hazard ratio 1.97, <i>p</i> < 0.001) and overall survival (median 36.1 vs. 16.6 months; hazard ratio 2.08, <i>p</i> < 0.001) were longer for those who received matched second-line therapy versus unmatched second-line therapy. In real-world practice, results of a blood-based NGS assay prior to second-line treatment inform therapeutic decisions that can improve clinical outcomes for patients with advanced NSCLC.https://www.mdpi.com/1718-7729/29/7/382actionable alterationscomprehensive genomic profilingctDNAnon-small cell lung cancertargeted therapy |
| spellingShingle | Steven Olsen Jiemin Liao Hidetoshi Hayashi Real-World Clinical Outcomes after Genomic Profiling of Circulating Tumor DNA in Patients with Previously Treated Advanced Non-Small Cell Lung Cancer Current Oncology actionable alterations comprehensive genomic profiling ctDNA non-small cell lung cancer targeted therapy |
| title | Real-World Clinical Outcomes after Genomic Profiling of Circulating Tumor DNA in Patients with Previously Treated Advanced Non-Small Cell Lung Cancer |
| title_full | Real-World Clinical Outcomes after Genomic Profiling of Circulating Tumor DNA in Patients with Previously Treated Advanced Non-Small Cell Lung Cancer |
| title_fullStr | Real-World Clinical Outcomes after Genomic Profiling of Circulating Tumor DNA in Patients with Previously Treated Advanced Non-Small Cell Lung Cancer |
| title_full_unstemmed | Real-World Clinical Outcomes after Genomic Profiling of Circulating Tumor DNA in Patients with Previously Treated Advanced Non-Small Cell Lung Cancer |
| title_short | Real-World Clinical Outcomes after Genomic Profiling of Circulating Tumor DNA in Patients with Previously Treated Advanced Non-Small Cell Lung Cancer |
| title_sort | real world clinical outcomes after genomic profiling of circulating tumor dna in patients with previously treated advanced non small cell lung cancer |
| topic | actionable alterations comprehensive genomic profiling ctDNA non-small cell lung cancer targeted therapy |
| url | https://www.mdpi.com/1718-7729/29/7/382 |
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