This article is divided into 2 parts:
Baseline ctDNA levels and patients Correlation of clinical outcomes
Correlation of early reduction of ctDNA with clinical outcomes of patients
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The researchers conducted a systematic search of electronic databases to include relevant studies published in English before November 2020. To assess the correlation between pretreatment ctDNA levels and early ctDNA kinetic changes and clinical outcomes in ICIs-treated advanced NSCLC patients. A total of 1017 patients in 10 studies were finally included in both qualitative and quantitative analyses.
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Association of baseline ctDNA levels with patient clinical outcomes
There was no significant difference in OS, PFS and ORR between patients with and without ctDNA detected at baseline, indicating that baseline ctDNA levels are not related to clinical outcomes of patients. related.
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Correlation between early reduction in ctDNA and clinical outcomes in patients strong>
Meta-analysis: Patients with reduced ctDNA 3-8 weeks after initiation of treatment had significantly longer OS and significantly higher ORR.
Meta-analysis/sensitivity analysis in patients with reduced ctDNA 3-8 weeks after initiation of therapy PFS was significantly prolonged.
Initial treatment subgroup analysis regardless of magnitude of reduction OS, PFS and ORR were significantly improved in patients with reduced ctDNA after 4-6 weeks.
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To conclude, in ICIs-experienced advanced NSCLC patients:
< span>There were no significant differences in OS, PFS and ORR between patients with and without ctDNA detected at baseline.
Irrespective of the magnitude of the reduction, patients with ctDNA reduction 4-6 weeks after initiation of therapy had significantly improved OS, PFS, and ORR.
In the future, more clinical studies are needed to further explore whether ctDNA can be used as a prognostic marker to evaluate the clinical efficacy of ICIs in NSCLC patients.
This concludes today’s literature interpretation. My name is Li Baozhong. I welcome colleagues to discuss with me further.
References:
< span>Wang H, Zhou F, Qiao M, et al. The Role of Circulating Tumor DNA in Advanced Non-Small Cell Lung Cancer Patients Treated With Immune Checkpoint Inhibitors: A Systematic Review and Meta-Analysis. Front Oncol. 2021;11: 671874. Published 2021 Jul 21.