Feasibility of disease recurrence monitoring in liver post-transplantation for patients with hepatocellular carcinoma via personalized and tumor-informed ctDNA test.

Authors

Maen Abdelrahim

Maen Abdelrahim

Houston Methodist Cancer Center, Houston, TX

Maen Abdelrahim , Abdullah Esmail , Ashish Saharia , Robert McMillan , Aiwu Ruth He , Jason S. Starr , Harmeet Dhani , Vasily N. Aushev , Allyson Koyen Malashevich , Nicole Hook Rattigan , Phil Gauthier , Adham Jarudi , Rafik Mark Ghobrial

Organizations

Houston Methodist Cancer Center, Houston, TX, Houston Methodist Jr Center for Transplantation and Sherrie and Alan Conover Center for Liver Disease and Transplantation, Houston, TX, Houston Methodist JC Walter Jr Center for Transplantation and Sherrie and Alan Conover Center for Liver Disease and Transplantation, Houston, TX, Division of Hematology and Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, University of Florida Health Cancer Center, Jacksonville, FL, Natera, San Carlos, CA, Natera, Inc., Austin, TX, Natera, Inc. Austin, TX, United States, Austin, TX

Research Funding

No funding received

Background: Hepatocellular carcinoma (HCC) is an aggressive malignancy for which liver transplantation can be curative. Unfortunately, ̃8-20% of HCC patients will go on to relapse post-transplantation. Personalized and tumor-informed circulating tumor DNA (ctDNA) testing (Signatera, bespoke mPCR NGS assay) has been validated to accurately predict relapse across solid tumors, ahead of radiological imaging. Here, we demonstrate the feasibility of ctDNA testing for monitoring relapse in HCC patients who underwent liver transplantation with curative intent. Methods: A total of 10 HCC patients, stage I-IV, who underwent curative liver transplantation with longitudinal ctDNA monitoring were included in the analysis. Alpha-fetoprotein (AFP) levels and images were measured during surveillance in a subset of patients. Results: In this cohort of 10 patients, 2 (20%) tested ctDNA positive during surveillance, both of whom relapsed. Of these, one tested ctDNA positive two months prior to imaging. Of the 8 patients who did not test ctDNA positive during surveillance, all remained disease-free by imaging. Two patients had elevated AFP, neither of whom relapsed. Of the 2 patients who relapsed, AFP levels were available for one patient and fell within the normal range. Conclusions: Our study illustrated the feasibility of performing longitudinal ctDNA assessment in patients with HCC (post-transplantation) during surveillance. ctDNA status but not AFP was associated with recurrence and was able to inform disease status ahead of imaging. To facilitate clinical decision-making, specifically with adjuvant therapy and immunosuppression management, additional studies with larger patient cohorts will be needed to validate the clinical utility of ctDNA testing in HCC.

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Abstract Details

Meeting

2022 ASCO Annual Meeting

Session Type

Publication Only

Session Title

Gastrointestinal Cancer—Gastroesophageal, Pancreatic, and Hepatobiliary

Track

Gastrointestinal Cancer—Gastroesophageal, Pancreatic, and Hepatobiliary

Sub Track

Hepatobiliary Cancer

Citation

J Clin Oncol 40, 2022 (suppl 16; abstr e16123)

DOI

10.1200/JCO.2022.40.16_suppl.e16123

Abstract #

e16123

Abstract Disclosures

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