Researchers at the Johns Hopkins Kimmel Cancer Center, the Bloomberg~Kimmel Institute for Cancer Immunotherapy, and Allegheny Health Network Cancer Institute have identified a new method to predict the response to immunotherapies and potential side effects in patients with advanced lung cancer. This innovative approach involves analyzing genetic material from tumors, which is released into the bloodstream, along with immune cells using a liquid biopsy.
The study involved 30 patients with metastatic non-small cell lung cancers who were treated with immunotherapies. By monitoring changes in circulating tumor DNA (ctDNA), the researchers were able to determine the molecular response, which refers to the clearance of tumor genetic material in the bloodstream. The presence of ctDNA was significantly associated with improved progression-free and overall survival rates.
Additionally, the researchers found that serial blood testing could detect the expansion of T cells, a type of immune cell that targets foreign or non-self molecules on tumor cells. This expansion was observed in patients who developed immune-related adverse events, such as lung tissue inflammation, as early as five months before the onset of clinical symptoms. These results were replicated in an independent cohort of 49 patients with advanced lung cancers at the Allegheny Health Network Cancer Institute.
Lead study author, Dr. Joseph Murray, explained the significance of these findings, stating that while immunotherapy has transformed the treatment of lung cancer, assessing treatment response has been challenging. The lack of reliable biomarkers has led clinicians to rely on imaging and patient symptoms to evaluate clinical response. However, with the use of noninvasive tests like liquid biopsies, the response can be studied and side effects predicted at an early stage, allowing for modifications to the treatment plan if necessary.
The liquid biopsy test also provided valuable insights into the clinical outcomes of patients with stable disease on imaging. Dr. Valsamo Elsa Anagnostou, senior study author, highlighted that these patients displayed different DNA molecular response patterns, which helped predict their overall clinical outcomes. This finding suggests that liquid biopsies can be particularly useful for a subset of patients who may benefit from tailored treatment strategies.
The study aligns with the ongoing efforts of the thoracic oncology group at Johns Hopkins to integrate liquid biopsies into clinical decision-making. Specifically, they are conducting a ctDNA-adaptive clinical trial of chemo-immunotherapy for patients with metastatic lung cancer. The hope is that liquid biopsies will guide therapeutic decision-making and provide a rapid and accurate assessment of cancer presence.
In conclusion, the use of liquid biopsies to analyze ctDNA and immune cells holds great promise in predicting immunotherapy response and identifying potential side effects in patients with advanced lung cancer. By providing valuable insights into treatment efficacy and personalized treatment plans, this innovative approach has the potential to improve patient outcomes and revolutionize lung cancer care.
1. Source: Coherent Market Insights, Public sources, Desk research
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