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Circulating tumour DNA kinetics in recurrent/metastatic head and neck squamous cell cancer patients.
Taylor, Kirsty; Zou, Jinfeng; Magalhaes, Marcos; Oliva, Marc; Spreafico, Anna; Hansen, Aaron R; McDade, Simon S; Coyle, Vicky M; Lawler, Mark; Elimova, Elena; Bratman, Scott V; Siu, Lillian L.
Afiliación
  • Taylor K; Division of Medical Oncology & Haematology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada; Patrick G. Johnston Centre for Cancer Research, Queen's University Belfast, Belfast, Northern Ireland, UK.
  • Zou J; Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
  • Magalhaes M; Division of Medical Oncology & Haematology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
  • Oliva M; Division of Medical Oncology & Haematology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
  • Spreafico A; Division of Medical Oncology & Haematology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
  • Hansen AR; Division of Medical Oncology & Haematology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
  • McDade SS; Patrick G. Johnston Centre for Cancer Research, Queen's University Belfast, Belfast, Northern Ireland, UK.
  • Coyle VM; Patrick G. Johnston Centre for Cancer Research, Queen's University Belfast, Belfast, Northern Ireland, UK.
  • Lawler M; Patrick G. Johnston Centre for Cancer Research, Queen's University Belfast, Belfast, Northern Ireland, UK.
  • Elimova E; Division of Medical Oncology & Haematology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
  • Bratman SV; Department of Radiation Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
  • Siu LL; Division of Medical Oncology & Haematology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada. Electronic address: lillian.siu@uhn.ca.
Eur J Cancer ; 188: 29-38, 2023 07.
Article en En | MEDLINE | ID: mdl-37182343
PURPOSE: Immune checkpoint blockade (ICB) has become a standard of care in the treatment of recurrent/metastatic head and neck squamous cell cancer (R/M HNSCC). However, only a subset of patients benefit from treatment. Quantification of plasma circulating tumour DNA (ctDNA) levels and on-treatment kinetics may permit real-time assessment of disease burden under selective pressures of treatment. PATIENTS AND METHODS: R/M HNSCC patients treated with systemic therapy, platinum-based chemotherapy (CT) or ICB, underwent serial liquid biopsy sampling. Biomarkers tested included ctDNA measured by CAncer Personalized Profiling by deep Sequencing (CAPP-Seq) and markers of host inflammation measured by neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR). RESULTS: Among 53 eligible patients, 16 (30%) received CT, 30 (57%) ICB [anti-PD1/L1] monotherapy and 7 (13%) combination immunotherapy (IO). Median progression-free survival (PFS) and overall survival (OS) were 2.8 months (95% CI, 1.3-4.3) and 8.2 months (95% CI, 5.6-10.8), respectively. Seven (13%) patients experienced a partial response and 21 (40%) derived clinical benefit. At baseline, median ctDNA variant allele frequency (VAF) was 4.3%. Baseline ctDNA abundance was not associated with OS (p = 0.56) nor PFS (p = 0.54). However, a change in ctDNA VAF after one cycle of treatment (ΔVAF (T1-2)) was predictive of both PFS (p< 0.01) and OS (p< 0.01). Additionally, decrease in ΔVAF identified patients with longer OS despite early radiological progression, 8.2 vs 4.6 months, hazard ratio 0.44 (95% CI, 0.19-0.87) p = 0.03. After incorporating NLR and PLR into multivariable Cox models, ctDNA ∆VAF retained an association with OS. CONCLUSIONS: Early dynamic changes in ctDNA abundance, after one cycle of treatment, compared to baseline predicted both OS and PFS in R/M HNSCC patients on systemic therapy.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de Células Escamosas / ADN Tumoral Circulante / Neoplasias de Cabeza y Cuello Tipo de estudio: Prognostic_studies Límite: Humans Idioma: En Revista: Eur J Cancer Año: 2023 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de Células Escamosas / ADN Tumoral Circulante / Neoplasias de Cabeza y Cuello Tipo de estudio: Prognostic_studies Límite: Humans Idioma: En Revista: Eur J Cancer Año: 2023 Tipo del documento: Article Pais de publicación: Reino Unido