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David S. Ettinger, MD, FACP, FCCP


Plasma T-Cell–Derived Circulating DNA Levels With Immunotherapy for Advanced-Stage NSCLC

By: Jenna Carter, PhD
Posted: Friday, December 16, 2022

A recent article published in the Journal of ImmunoTherapy of Cancer and previously presented at the 2022 Society for Immunotherapy of Cancer (SITC) Annual Meeting (Abstract 33) highlighted the impact of using T-cell–derived circulating DNA (T-cirDNA) levels as a predictive diagnostic tool for anti–PD-L1 immunotherapy in patients with advanced-stage non–small cell lung cancer (NSCLC). Nuthchaya Mejun, PhD, of Chulalongkorn University, Bangkok, Thailand, and colleagues examined T-cirDNA/circulating DNA, in patients treated with anti–PD-L1 immunotherapy. They found that the group with undetectable plasma levels of T-cirDNA had favorable progression-free survival and the longest overall survival.

A total of 47 patients with advanced-stage NSCLC treated with anti–PD-L1 immunotherapy were included in this study. Patients were placed into undetectable, low (< 1%), and high (> 1%) T-cirDNA groups, based on previous studies.

Overall findings revealed a correlation between the undetectable group and the longest overall survival, with a median of 25.5 months (P = .05). Multivariate analysis of progression-free survival revealed an Eastern Cooperative Oncology Group performance status of 0 to 1, and undetectable T-cirDNA correlated with favorable outcomes (hazard ratio [HR] = 0.05, P = .005; and HR = 0.1, P = .02; respectively). A high level of circulating DNA that represented high tumor burden and single-agent anti–PD-L1 immunotherapy were correlated with unfavorable disease control (HR = 6.6, P = .03; and HR = 6.3, P = .01), respectively. For the detectable T-cirDNA group, high levels versus low levels were correlated with better disease control (HR = 0.1, P = .03).

Based on these findings, the study authors concluded that T-cell–derived circulating DNA could be used as a clinical predictor of anti–PD-L1 immunotherapy in this patient population.

Disclosure: For full disclosures of the study authors, visit

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