Results of Early Monitoring of Circulating Tumor DNA in Resected Early-Stage Non-Small Cell Lung Cancer

Among the questions that cancer patients ask following their surgeries are, “Will it come back? Do I need additional treatment?”

Circulating tumor DNA (ctDNA) offers a possible tool for answering those questions. ctDNA found in the bloodstream comes from cancerous cells and tumors; and monitoring ctDNA in patients with resected early-stage non-small cell lung cancer (NSCLC) could aid in detecting and managing recurrence.

Aaron Dinerman, MD, Baylor University Medical Center, Baylor Scott & White System, and coauthors evaluated the impact of early real-world experience of monitoring ctDNA among these patients.

Beginning in October 2021, post-operative ctDNA was monitored for all surgically resected NSCLC patients (76) at the Baylor Medical Center. Peripheral blood samples were collected for ctDNA at 3-month intervals. Of those 76 patients, eight were positive for ctDNA. Post-operative clinical care was altered for seven of the eight; five received an earlier surveillance CT scan, and six received early PET-CT scan. Six of the ctDNA-positive patients had a biopsy-proven recurrence and were directed into therapy; two have not demonstrated radiographic evidence of recurrence but were directed into earlier interval surveillance.

The serial monitoring of ctDNA following resection of early-stage NSCLC resulted in early detection of recurrent cancer and led to early surveillance and/or unexpected medical oncology referral in seven of the eight patients with positive ctDNA. (One patient demonstrated recurrence [brain metastases] with a negative ctDNA level.) This study exemplifies the impact of ctDNA on surveillance and management in early stage resected NSCLC. Further multicenter studies are required to determine protocol-specific best practices.

Travis Martin, DO, of the University of North Texas Health Science Center, will present the results of this study and its implications Sunday, May 7, at the American Association for Thoracic Surgery (AATS) 103rd Annual Meeting in Los Angeles.