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Gregory J. Riely, MD, PhD


AACR 2023: Surveillance of NSCLC Using Novel Circulating Tumor DNA Analysis

By: Emily Rhode
Posted: Tuesday, April 18, 2023

The novel patient-specific, tumor-informed measurable residual disease (MRD) panel known as PROPHET appears to be an effective tool for prognosis prediction and disease assessment in patients with non–small cell lung cancer (NSCLC), according to a study presented at the American Association for Cancer Research (AACR) Annual Meeting 2023 (Abstract 1039/16). Based on these results, Kezhong Chen, MD, of Peking University People’s Hospital, Beijing, and colleagues proposed that using PROPHET could be an advantageous surveillance tool over fixed tumor-informed and tumor-naive MRD panels in prognostic and disease assessment of this patient population.

The study enrolled a total of 181 patients with stage I (63%), II (19%), and III (18%) NSCLC from the MEDAL study, which had previously directly compared PROPHET with fixed-panel monitoring. Researchers collected and analyzed 760 plasma samples at key points throughout the trial, including baseline (n = 157), at the landmark points of day 3 and month 1(n = 334), and at longitudinal points (n -248). Plasma samples (n = 21) were also collected from 14 patients who relapsed during the trial. The PROPHET assay used deep sequencing to customize a panel of 50 patient-specific, single-nucleotide variants to detect and quantify MRD. These results were then compared with tumor-informed and tumor-agnostic fixed-panel assays from the same samples.

PROPHET had a higher positive rate for detecting circulating tumor DNA compared with the tumor-informed and tumor-agnostic fixed-panel assays (22% and 19%, respectively). The landmark PROPHET-based MRD status was a strong predictor of clinical relapse (P < .001), according to the investigators, and when combined with the clinical TNM stage, it outperformed TNM stage alone in predicting prognosis (P < .001). Longitudinal MRD achieved a high negative predictive value (99%) with a longer lead time (299 days) than other advanced fixed-panel assays.

Disclosure: For full disclosures of the study authors, visit

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