Real-World Clinical Outcomes after Genomic Profiling of Circulating Tumor DNA in Patients with Previously Treated Advanced Non-Small Cell Lung Cancer
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- Steven Olsen
- Department of Medical and Clinical Affairs, Guardant Health Japan Corp., Minato-ku, Tokyo 105-7590, Japan
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- Jiemin Liao
- Department of Outcomes and Evidence, Guardant Health Inc., Redwood City, CA 94063, USA
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- Hidetoshi Hayashi
- Department of Medicine, Kindai University, Osaka-Sayama, Osaka 589-8511, Japan
説明
<jats:p>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 (GuardantINFORMTM, Guardant Health) who underwent next-generation sequencing (NGS)-based circulating tumor DNA (ctDNA) testing (Guardant360®, 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 EGFR (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, p < 0.001) and overall survival (median 36.1 vs. 16.6 months; hazard ratio 2.08, p < 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.</jats:p>
収録刊行物
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- Current Oncology
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Current Oncology 29 (7), 4811-4826, 2022-07-08
MDPI AG
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キーワード
- Lung Neoplasms
- comprehensive genomic profiling
- Neoplasms. Tumors. Oncology. Including cancer and carcinogens
- High-Throughput Nucleotide Sequencing
- ctDNA
- Genomics
- targeted therapy
- Article
- actionable alterations; comprehensive genomic profiling; ctDNA; non-small cell lung cancer; targeted therapy
- Circulating Tumor DNA
- Carcinoma, Non-Small-Cell Lung
- Humans
- actionable alterations
- non-small cell lung cancer
- RC254-282
- Aged