多西紫杉醇
阿替唑单抗
医学
内科学
肿瘤科
危险系数
肺癌
临床终点
一致性
化疗
置信区间
癌症
临床试验
无容量
免疫疗法
作者
Wei Zou,Stephanie J. Yaung,Frederike Fuhlbrück,Marcus Ballinger,Eric Peters,John F. Palma,David S. Shames,David R. Gandara,Yuqiu Jiang,Namrata S. Patil
出处
期刊:JCO precision oncology
[American Society of Clinical Oncology]
日期:2021-05-12
卷期号: (5): 827-838
被引量:40
摘要
PURPOSE Identification of predictors for overall survival (OS) allows timely detection of clinical efficacy signals and therefore facilitates treatment decisions. We assessed the association between circulating tumor DNA (ctDNA) metrics and the primary end point of OS in a subset of previously treated patients with locally advanced or metastatic non–small-cell lung cancer, who underwent atezolizumab or docetaxel treatment in the open-label randomized phase III OAK trial. MATERIALS AND METHODS Plasma from 94 patients at baseline and at subsequent cycles of therapy every 3 weeks was analyzed retrospectively for ctDNA. ctDNA was measured by allele frequency and mutant molecules per milliliter (MMPM). Concordance between various per-sample metrics and clinical outcome were assessed using C index. RESULTS Of all the ctDNA metrics tested, the association of median MMPM at 6 weeks with OS in patients treated with atezolizumab or docetaxel had a C index > 0.7. The OS hazard ratios relative to high ctDNA above median MMPM within each arm were 0.28 (95% CI, 0.11 to 0.75) for atezolizumab and 0.19 (95% CI, 0.08 to 0.48) for docetaxel. For patients who had ctDNA median MMPM levels of < 4.79, the median survival time was more than 17 months in docetaxel-treated patients and the median survival time was not reached in the atezolizumab-treated patients. CONCLUSION ctDNA MMPM levels measured at 6 weeks post-treatment are associated with OS in advanced non–small-cell lung cancer. Our results suggest that ctDNA has the potential for a noninvasive early liquid biopsy predictor for OS that warrants further studies to demonstrate its utility in clinical development.
科研通智能强力驱动
Strongly Powered by AbleSci AI