Real-World Evidence for Liquid Biopsy to Identify Molecular Alterations

Web Exclusives — December 7, 2022

Identifying molecular alterations in patients with cancer is an important component of personalized therapy, which is supported by a growing body of evidence. Liquid biopsy, or cell-free DNA analysis, is a novel, noninvasive approach for identifying molecular alterations that has been confirmed in clinical trials but real-world evidence has not yet been examined. This prospective, real-world study sought to examine liquid biopsy in international patients with cancer, specifically with the intent to offer personalized therapies.

Patients were admitted to the international department of Gustave Roussy with advanced solid cancers. Cell-free DNA was extracted from the patients’ (N = 47) peripheral blood and sent for sequencing.

The median age of the patients was 60.5 years, and 53% of the patients were men. The primary site of cancer for these patients varied and included digestive (n = 20; 41%), lung (n = 9; 19%), sarcomas (n = 6; 13%), breast (n = 5; 11%), and other (n = 7; 16%). Treatment history also varied: 17 patients (36.2%) were treatment-naïve, 34 (73.3%) were previously treated with chemotherapy, and 16 (34%) were previously treated with immunotherapy. On the day of liquid biopsy, 43 patients (91.5%) had distant metastases. Patients with Eastern Cooperative Oncology Group Performance Status scores 0-1 and ≥2 were split evenly with 24 patients (50%) in each group. The median number of previous lines of therapy was 1.

Only 2 patients had insufficient cell-free DNA to complete the liquid biopsy. For the remaining patients, the median number of molecular alterations was 5. In 7 patients, the tumor mutational burden was ≥10, suggesting that immunotherapy may be a treatment option. In addition, 10 molecular alterations with available options for treatment were identified in 9 patients: KRAS G12C (1 lung, 1 pancreatic), EGFR (1 lung), IDH1 (1 cholangiocarcinoma), BRAF (1 angiosarcoma, 1 colon), BRCA2 (1 pancreatic), PIK3CA (2 breast), and FGFR3 (1 bladder). Oncoprint genes were altered in ≥5% of patients.

The identification of the molecular alterations allowed for 15 patients (31.9%) to be offered an innovative approach to treatment. In addition, 16 patients (with 22 molecular alterations among them) were identified as potential participants in phase 1 or 2 clinical trials.

This study supports the role of liquid biopsy as a tool to identify molecular alterations with diagnostic and therapeutic implications.

Source: Assi TS, Ibrahim T, Chahine C, et al. Liquid biopsy, a tool to detect genetic alterations with therapeutic impact in international patients: prospective data on 47 patients from Gustave Roussy. Ann Oncol. 2022;33(suppl 7):S580.

Related Items

The Impact of mFOLFOX Chemotherapy in Conjunction with Active Symptom Control on Patient QOL: The ABC-06 Trial
Web Exclusives
Preliminary analyses of patient quality-of-life data from the ABC-06 clinical trial suggest a potentially positive impact of L-folinic acid plus oxaliplatin plus 5-fluorouracil when used in conjunction with active symptom control.
Derazantinib Shows Clinical Efficacy in the Treatment of iCCA in Patients with Genetically Aberrant FGFR2
Web Exclusives
Data from the FIDES-01 clinical trial showed encouraging results for derazantinib as a second-line treatment for patients with intrahepatic cholangiocarcinoma with FGFR2 fusions, mutations, or amplification.
FGFR Inhibitor RLY-4008 Shows Promise in Treating Metastatic CCA
Web Exclusives
Early data from the ReFocus trial indicated that the highly selective FGFR2 inhibitor RLY-4008 may be an effective new treatment for cholangiocarcinoma in patients with FGFR2 fusions or rearrangements.
Nanoliposomal Irinotecan Combination Therapy Falls Short in Metastatic BTC
Web Exclusives
The NALIRICC study compared the efficacy of nanoliposomal irinotecan plus 5-fluorouracil (5-FU) plus leucovorin (LV) with 5-FU plus LV on progression-free and overall survival in patients with biliary tract cancer.
Tislelizumab as Part of a Conversion Therapy Regimen for Potentially Resectable Biliary Tract Cancers
Web Exclusives
A phase 2 study found that the combination of tislelizumab, lenvatinib, and gemcitabine/oxaliplatin showed promise as a conversion therapy for patients with potentially resectable locally advanced biliary tract cancer, making curative surgery a possibility for some patients.
Additional 6-Month Follow-up from the TOPAZ-1 Study Comparing Durvalumab with Placebo plus Gem/Cis in Patients with Advanced BTC
Web Exclusives
Updated overall survival (OS) and safety data from the TOPAZ-1 study revealed improved median OS for the full patient population as well as subgroup analyses and an adverse event profile consistent with previously reported data.
Immune-Related Adverse Events in the TOPAZ-1 Study of Durvalumab or Placebo plus GemCis in Advanced BTC
Web Exclusives
Analysis of the safety population in the TOPAZ-1 trial in patients with biliary tract cancer revealed that immune-related adverse events were more common in the durvalumab arm, had a variable time to onset, and were associated with improved overall survival.
CCA Summit Live from ESMO 2022
By Juan W. Valle, MB ChB, MSc, FRCP
On September 21, 2022, I presented an overview of key abstracts on biliary tract cancer (BTC) presented at the 2022 annual meeting of the European Society for Medical Oncology. In addition, I provided my perspective on the impact of the data on the management of patients with BTC.
Key Abstracts Presented at the European Society for Medical Oncology (ESMO) 2021 Annual Meeting
By Richard Kim, MD
Richard Kim, MD, from the Moffitt Cancer Center, University of South Florida College of Medicine, provides expert commentary on key abstracts and posters presented at the 2021 annual meeting of the European Society for Medical Oncology. Dr Kim will highlight new data from 11 presentations on interventional modalities for patients with cholangiocarcinoma.
Futibatinib Safe and Effective in Patients with Advanced or Metastatic Intrahepatic Cholangiocarcinoma and FGFR2 Fusions
October 2020, Vol 1, No 2
Two phase 2 studies of futibatinib, a highly selective irreversible fibroblast growth factor receptor (FGFR)1-4 inhibitor, analyzed data from the FOENIX-CCA2 clinical trial and were presented at the 2020 virtual meeting of the European Society for Medical Oncology (ESMO).

Subscribe Today!

To sign up for our newsletter or print publications, please enter your contact information below.

I'd like to receive: