Role of next generation sequencing-based liquid biopsy in advanced non-small cell lung cancer patients treated with immune checkpoint inhibitors: impact of STK11, KRAS and TP53 mutations and co-mutations on outcome.

Immunotherapy STK11 circulating tumor DNA lung cancer predictive biomarkers

Journal

Translational lung cancer research
ISSN: 2218-6751
Titre abrégé: Transl Lung Cancer Res
Pays: China
ID NLM: 101646875

Informations de publication

Date de publication:
Jan 2021
Historique:
entrez: 11 2 2021
pubmed: 12 2 2021
medline: 12 2 2021
Statut: ppublish

Résumé

Characterization of tumor-related genetic alterations is promising for the screening of new predictive markers in non-small cell lung cancer (NSCLC). Aim of the study was to evaluate prognostic and predictive role of most frequent tumor-associated genetic alterations detected in plasma before starting immune checkpoint inhibitors (ICIs). Between January 2017 and October 2019, advanced NSCLC patients were prospectively screened with plasma next-generation sequencing (NGS) while included in two trials: VISION (NCT02864992), using Guardant360 A total of 103 patients receiving ICIs were analyzed: median overall survival (OS) was 20.8 (95% CI: 16.7-24.9) months and median immune-related progression free disease (irPFS) 4.2 (95% CI: 2.3-6.1) months. TP53 mutations in plasma negatively affected OS both in patients treated with ICIs and in control group (P=0.001 and P=0.009), indicating a prognostic role. STK11 mutated patients (n=9) showed a trend for worse OS only if treated with ICIs. The presence of KRAS/STK11 co-mutation and KRAS/STK11/TP53 co-mutation affected OS only in patients treated with ICIs (HR =10.936, 95% CI: 2.337-51.164, P=0.002; HR =17.609, 95% CI: 3.777-82.089, P<0.001, respectively), indicating a predictive role. Plasma genotyping demonstrated prognostic value of TP53 mutations and predictive value of KRAS/STK11 and KRAS/STK11/TP53 co-mutations.

Sections du résumé

BACKGROUND BACKGROUND
Characterization of tumor-related genetic alterations is promising for the screening of new predictive markers in non-small cell lung cancer (NSCLC). Aim of the study was to evaluate prognostic and predictive role of most frequent tumor-associated genetic alterations detected in plasma before starting immune checkpoint inhibitors (ICIs).
METHODS METHODS
Between January 2017 and October 2019, advanced NSCLC patients were prospectively screened with plasma next-generation sequencing (NGS) while included in two trials: VISION (NCT02864992), using Guardant360
RESULTS RESULTS
A total of 103 patients receiving ICIs were analyzed: median overall survival (OS) was 20.8 (95% CI: 16.7-24.9) months and median immune-related progression free disease (irPFS) 4.2 (95% CI: 2.3-6.1) months. TP53 mutations in plasma negatively affected OS both in patients treated with ICIs and in control group (P=0.001 and P=0.009), indicating a prognostic role. STK11 mutated patients (n=9) showed a trend for worse OS only if treated with ICIs. The presence of KRAS/STK11 co-mutation and KRAS/STK11/TP53 co-mutation affected OS only in patients treated with ICIs (HR =10.936, 95% CI: 2.337-51.164, P=0.002; HR =17.609, 95% CI: 3.777-82.089, P<0.001, respectively), indicating a predictive role.
CONCLUSIONS CONCLUSIONS
Plasma genotyping demonstrated prognostic value of TP53 mutations and predictive value of KRAS/STK11 and KRAS/STK11/TP53 co-mutations.

Identifiants

pubmed: 33569305
doi: 10.21037/tlcr-20-674
pii: tlcr-10-01-202
pmc: PMC7867770
doi:

Types de publication

Journal Article

Langues

eng

Pagination

202-220

Informations de copyright

2021 Translational Lung Cancer Research. All rights reserved.

Déclaration de conflit d'intérêts

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/tlcr-20-674). RR serves as a current Editor-in-chief for Translational Lung Cancer Research. The other authors have no conflicts of interest to declare.

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Auteurs

Alberto Pavan (A)

Medical Oncology 2, Istituto Oncologico Veneto IOV - IRCCS, Padova, Italy.

Andrea Boscolo Bragadin (AB)

Department of Surgery, Oncology and Gastroenterology, Università degli Studi di Padova, Padova, Italy.

Lorenzo Calvetti (L)

Department of Oncology, San Bortolo General Hospital, ULSS8 Berica - East District, Vicenza, Italy.

Alessandra Ferro (A)

Medical Oncology 2, Istituto Oncologico Veneto IOV - IRCCS, Padova, Italy.
Department of Surgery, Oncology and Gastroenterology, Università degli Studi di Padova, Padova, Italy.

Elisabetta Zulato (E)

Immunology and Molecular Oncology Unit, Istituto Oncologico Veneto IOV - IRCCS, Padova, Italy.

Ilaria Attili (I)

Medical Oncology 2, Istituto Oncologico Veneto IOV - IRCCS, Padova, Italy.
Department of Surgery, Oncology and Gastroenterology, Università degli Studi di Padova, Padova, Italy.

Giorgia Nardo (G)

Immunology and Molecular Oncology Unit, Istituto Oncologico Veneto IOV - IRCCS, Padova, Italy.

Alessandro Dal Maso (A)

Medical Oncology 2, Istituto Oncologico Veneto IOV - IRCCS, Padova, Italy.
Department of Surgery, Oncology and Gastroenterology, Università degli Studi di Padova, Padova, Italy.

Stefano Frega (S)

Medical Oncology 2, Istituto Oncologico Veneto IOV - IRCCS, Padova, Italy.

Andrea Giovanni Menin (AG)

Department of Pathology, San Bortolo General Hospital, ULSS8 Berica - East District, Vicenza, Italy.

Matteo Fassan (M)

Department of Medicine, Surgical Pathology and Cytopathology Unit, Università degli Studi di Padova, Padova, Italy.

Fiorella Calabrese (F)

Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Università degli Studi di Padova, Padova, Italy.

Giulia Pasello (G)

Medical Oncology 2, Istituto Oncologico Veneto IOV - IRCCS, Padova, Italy.

Valentina Guarneri (V)

Medical Oncology 2, Istituto Oncologico Veneto IOV - IRCCS, Padova, Italy.
Department of Surgery, Oncology and Gastroenterology, Università degli Studi di Padova, Padova, Italy.

Giuseppe Aprile (G)

Department of Oncology, San Bortolo General Hospital, ULSS8 Berica - East District, Vicenza, Italy.

PierFranco Conte (P)

Medical Oncology 2, Istituto Oncologico Veneto IOV - IRCCS, Padova, Italy.
Department of Surgery, Oncology and Gastroenterology, Università degli Studi di Padova, Padova, Italy.

Rafael Rosell (R)

Cancer Biology and Precision Medicine Program, Catalan Institute of Oncology, Germans Trias I Pujol Health Sciences Institute and Hospital Badalona, Barcelona, Spain.

Stefano Indraccolo (S)

Immunology and Molecular Oncology Unit, Istituto Oncologico Veneto IOV - IRCCS, Padova, Italy.

Laura Bonanno (L)

Medical Oncology 2, Istituto Oncologico Veneto IOV - IRCCS, Padova, Italy.

Classifications MeSH