Implementing Circulating Tumor DNA As a Prognostic Biomarker in Resectable Non-Small Cell Lung Cancer

Chris Abbosh,Darren Hodgson,Gary J. Doherty,Davina Gale,James R.M. Black,Leora Horn,Jorge S. Reis-Filho,Charles Swanton

Trends in cancer（2024）

Cancer Biomarker Development | Late Development Oncology | Cancer Research UK Lung Cancer Centre of Excellence | Clinical Development

Cited 4|Views27

Abstract

Systemic treatment of resectable non-small cell lung cancer (NSCLC) is evolving with emerging neoadjuvant, perioperative, and adjuvant immunotherapy approaches. Circulating tumor DNA (ctDNA) detection at clinical diagnosis, during neoadjuvant therapy, or after resection may discern high-risk patients who might benefit from therapy escalation or switch. This Review summarizes translational implications of data supporting ctDNA-based risk determination in NSCLC and outstanding questions regarding ctDNA validity/utility as a prognostic biomarker. We discuss emerging ctDNA capabilities to refine clinical tumor–node–metastasis (TNM) staging in lung adenocarcinoma, ctDNA dynamics during neoadjuvant therapy for identifying patients deriving suboptimal benefit, and postoperative molecular residual disease (MRD) detection to escalate systemic therapy. Considering differential relapse characteristics in landmark MRD-negative/MRD-positive patients, we propose how ctDNA might integrate with pathological response data for optimal postoperative risk stratification.

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Key words

biomarker,ctDNA,molecular residual disease,non-small cell lung cancer,resectable,staging

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We show that M6 outperforms the baselines in multimodal downstream tasks, and the large M6 with 10 parameters can reach a better performance
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