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Gregory J. Riely, MD, PhD
Gregory J. Riely, MD, PhD
Posted: Tuesday, October 1, 2024
Luiza Doro, MD, of the University of Connecticut, Farmington, and colleagues evaluated the clinical utility of molecular profiling via upfront liquid biopsy to screen for targetable genetic abnormalities in patients with non–small cell lung cancer (NSCLC). During the 2024 American Society of Clinical Oncology (ASCO) Quality Care Symposium (Abstract 316), these investigators identified actionable mutations in 35% of patients, 84% of whom were treatment-naive.
“Upfront liquid biopsy identified a significant proportion of patients with targetable mutations,” the study authors concluded. “Our results complement prior literature and [show] that blood next-generation sequencing can be a useful tool to guide upfront [therapeutic] options at the community health-care setting.”
This study retrospectively reviewed the data on 112 patients with NSCLC who had a liquid biopsy performed between December 2017 and February 2022. Liquid biopsies underwent broad molecular profiling and were tested for mutations in EGFR, ALK, ROS1, and BRAF. A 73-gene panel by Guardant 360 test was used to conduct plasma genotyping, and targetable mutations were stratified using the OncoKB database, based on evidence of drug actionability.
Approximately 78% of patients underwent liquid biopsy at their initial diagnosis. Oncogenic mutations were identified in 86 participants, and 43 had targetable mutations; 29% of these fell under level 1 evidence mutations. Of interest, mutations in KRAS G12C (11%) and EGFR (23%) were the most common level 1 genetic aberrations.
Genetic counseling was offered to two patients who were germline BRCA carriers. Based on liquid biopsy results, 25 patients received appropriate treatment; 15 of these individuals achieved a partial response to therapy. Of six patients who underwent liquid biopsy at disease progression on MET or EGFR therapy, three appeared to harbor a resistance mechanism.
Disclosure: The study authors reported no conflicts of interest.
2024 ASCO Quality Care Symposium
