A tumor-naive ctDNA assay detects minimal residual disease in resected stage II or III colorectal cancer and predicts recurrence: subset analysis from the GALAXY study in CIRCULATE-Japan

IF 10 1区 医学 Q1 ONCOLOGY Clinical Cancer Research Pub Date : 2024-11-08 DOI:10.1158/1078-0432.ccr-24-2396
Yoshiaki Nakamura, Kristiyana Kaneva, Christine Lo, Daniel Neems, Jonathan E. Freaney, Hala Boulos, Seung Won Hyun, Farahnaz Islam, Jason Yamada-Hanff, Terri M. Driessen, Anne Sonnenschein, Dana F. DeSantis, Daisuke Kotani, Jun Watanabe, Masahito Kotaka, Saori Mishima, Hideaki Bando, Kentaro Yamazaki, Hiroya Taniguchi, Ichiro Takemasa, Takeshi Kato, Chithra Sangli, Robert Tell, Richard Blidner, Takayuki Yoshino, Kate Sasser, Eiji Oki, Halla Nimeiri
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Abstract

Purpose: Analysis of circulating tumor DNA (ctDNA) may enable early identification of patients likely to relapse, presenting an opportunity for early interventions and improved outcomes. Tumor-naïve plasma-only approaches for molecular residual disease (MRD) assessment accelerate turnaround time, enabling rapid treatment decisions and ongoing surveillance. Experimental Design: Plasma samples were obtained from 80 study participants with stage II or III colorectal cancer (CRC) selected from CIRCULATE-Japan GALAXY. MRD status was assessed using a tumor-naïve ctDNA assay (xM) that integrates methylation and genomic variant data, delivering a binary call. MRD was assessed at 4 weeks post-surgery (landmark timepoint (LMT)) using methylation and genomic variant data and longitudinally (median 22.1 months) using only methylation data. Results: At LMT, 69/80 study participants were evaluable (36 recurrent; 33 non-recurrent). Of recurrent study participants, 22/36 had detectable ctDNA (MRD+) at LMT and 29/33 non-recurrent study participants had undetectable ctDNA (MRD-), yielding clinical sensitivity of 61.1% and specificity of 87.9%. Additionally, 74 study participants were evaluable for longitudinal performance with a clinical sensitivity of 83.3% and specificity of 89.5%. Median lead time from first MRD+ result to recurrence was 4.77 months overall, and 5.30 months for study participants with no adjuvant treatment. At 12 weeks post-surgery, MRD status strongly correlated with disease-free survival (DFS) [adj. HR 9.69], outperforming carcinoembryonic antigen (CEA) correlation [HR 2.13]. Conclusions: This tumor-naïve MRD assay demonstrated clinically meaningful performance at LMT and longitudinally, accurately predicting clinical recurrence. MRD status was a stronger prognostic biomarker to DFS compared to standard of care CEA.
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无肿瘤ctDNA测定可检测切除的II期或III期结直肠癌中的极小残留病并预测复发:日本CIRCULATE的GALAXY研究子集分析
目的:循环肿瘤 DNA(ctDNA)分析可及早识别可能复发的患者,为早期干预和改善预后提供机会。用于分子残留病(MRD)评估的纯肿瘤血浆方法可加快周转时间,从而实现快速治疗决策和持续监测。实验设计:从 CIRCULATE-Japan GALAXY 中挑选的 80 名 II 期或 III 期结直肠癌 (CRC) 研究参与者采集血浆样本。MRD 状态是通过一种整合了甲基化和基因组变异数据并提供二元调用的肿瘤免疫ctDNA测定(xM)来评估的。使用甲基化和基因组变异数据在术后4周(标志性时间点(LMT))评估MRD,仅使用甲基化数据纵向评估MRD(中位22.1个月)。结果:在里程碑时间点,69/80 名研究参与者可进行评估(36 名复发;33 名非复发)。在复发性研究参与者中,22/36 在 LMT 检测到 ctDNA(MRD+),29/33 非复发性研究参与者检测不到 ctDNA(MRD-),临床敏感性为 61.1%,特异性为 87.9%。此外,74 名研究参与者可进行纵向表现评估,临床灵敏度为 83.3%,特异性为 89.5%。从首次MRD+结果到复发的中位时间为4.77个月,未接受辅助治疗的研究参与者的中位时间为5.30个月。术后12周时,MRD状态与无病生存期(DFS)密切相关[adj. HR 9.69],优于癌胚抗原(CEA)相关性[HR 2.13]。结论:这种对肿瘤不敏感的 MRD 检测方法在 LMT 和纵向上都表现出了有临床意义的性能,能准确预测临床复发。与标准疗法 CEA 相比,MRD 状态是更强的 DFS 预后生物标志物。
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来源期刊
Clinical Cancer Research
Clinical Cancer Research 医学-肿瘤学
CiteScore
20.10
自引率
1.70%
发文量
1207
审稿时长
2.1 months
期刊介绍: Clinical Cancer Research is a journal focusing on groundbreaking research in cancer, specifically in the areas where the laboratory and the clinic intersect. Our primary interest lies in clinical trials that investigate novel treatments, accompanied by research on pharmacology, molecular alterations, and biomarkers that can predict response or resistance to these treatments. Furthermore, we prioritize laboratory and animal studies that explore new drugs and targeted agents with the potential to advance to clinical trials. We also encourage research on targetable mechanisms of cancer development, progression, and metastasis.
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