Liquid biopsy detection of tumor shed in cancers for which molecular profiling is best practice.

Authors

Pashtoon Kasi

Pashtoon Murtaza Kasi

University of Iowa, Iowa City, IA

Pashtoon Murtaza Kasi, Caroline Weipert, Julie Kaylor

Organizations

University of Iowa, Iowa City, IA, Guardant Health, Inc., Redwood City, CA, Clemson University, Clemson, SC

Research Funding

No funding received
None.

Background: Technology and innovation in genomic profiling provides an opportunity to improve the outcomes of advanced solid cancer patients including some cancer agnostic approved therapies, and biomarker analysis is recommended within NCCN guidelines for 15 solid cancers. Tissue-based molecular profiling may not be efficient or feasible for many patients due to factors such as fitness for procedure, timeliness to treatment, and sample exhaustion, leading to healthcare disparities. Despite robust validation and regulatory approval for use in genomic profiling across all advanced solid tumors, circulating tumor DNA (ctDNA) or “liquid biopsy” is included within NCCN guidelines for 9 solid cancers. The utility of ctDNA based profiling in additional cancers for which molecular analysis is recommended is contingent upon the ability to reliably detect tumor shed and biomarkers of interest. Methods: Results were analyzed for a large nationwide cohort over 40,000 patients seen across community and academic settings receiving Guardant360 CDx or Guardant360 (Guardant Health, Redwood City, CA) in a 6-month window to evaluate detection of ctDNA, or tumor shed, among cancers for which guidelines do and do not currently include liquid biopsy. Results: Tumor shed was detected in 83%-92% (median 89%) of cancers for which guidelines include liquid biopsy, and 73%-94% (median 88%) for those without guideline inclusion for liquid biopsy. The detection of tumor shed was similar among cancer types with and without liquid biopsy inclusion in guidelines (p value = 0.5014; two-tailed t-test). Conclusions: The non-invasive nature of liquid biopsy, rapid turnaround, and sufficient tumor shed (as shown by results of this study) further support the inclusion of liquid biopsy in NCCN guidelines when molecular profiling is indicated. For tumors where it may replace the need for tissue biopsy acquisition, a plasma-first approach incorporating a liquid biopsy can reduce the financial toxicity as it would be more efficient and cost-effective.

ctDNA detected, %
Guidelines recommend liquid biopsy

CRC
92%
Lung
91%
Urogenital, Male
90%
Breast
89%
Pancreatic Adenocarcinoma
89%
Gastric/Esophageal
87%
Skin
83%
Guidelines recommend molecular profiling but do not include liquid biopsy
Bladder
94%
Ovarian
94%
Cholangiocarcinoma
92%
Other GI
92%
CUP
91%
Endometrial
91%
Cervix
88%
Other
88%
Head & Neck
85%
Kidney
82%
GIST
80%
Bone/Soft Tissue
80%
Thyroid
73%

Disclaimer

This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org

Abstract Details

Meeting

2022 ASCO Quality Care Symposium

Session Type

Poster Session

Session Title

Poster Session B

Track

Palliative and Supportive Care,Technology and Innovation in Quality of Care,Quality, Safety, and Implementation Science

Sub Track

Real-World Evidence

Citation

J Clin Oncol 40, 2022 (suppl 28; abstr 412)

DOI

10.1200/JCO.2022.40.28_suppl.412

Abstract #

412

Poster Bd #

F15

Abstract Disclosures