Application of liquid biopsy in early detection of lung cancer

Release date: 2018-06-06

It is well known that early treatment of cancer can significantly improve overall survival, but early detection methods are clearly not mature enough. At the 2018 ASCO meeting on Monday, researchers at the Dana–Farber Cancer Institute in the United States reported on their ongoing cycle-free cell-free genomic map (CCGA) study, suggesting that liquid biopsy techniques for analyzing free DNA in blood can detect early Lung cancer.

Related data has been published at the ASCO Annual Meeting No. 4 under the title "Genome-Wide Sequencing for Early Stage Lung Cancer Detection from Plasma Cell-Free DNA (cfDNA): The Circulating Cancer Genome Atlas (CCGA) study".

01. Research results

Specifically, CCGA research recruited more than 12,000 participants in 141 locations in the United States and Canada (70% with cancer and 30% without cancer).

The new report comes from the first sub-study of CCGA, in which they performed three prototype sequencing analyses of blood samples from approximately 1,700 participants. Twenty different cancer types at all stages were included in the study (the early results of this study, including breast, gastrointestinal, gynecological, blood, and other cancers, have been presented at the 2018 ASCO Annual Meeting) Published).

The researchers then explored the ability of these three assays to detect cancer in 127 patients with stage I-IV lung cancer, with the goal of detecting cancer-defined signals (ie, mutations and other genomic changes) that could be used in early cancer testing.

The authors wrote: “We evaluated participants with lung cancer (127 people) (pts) and a group of controls with similar age (580 people), 85% and 43% were smokers, 46% and 22% are men."

Preliminary results show that all three methods can detect lung cancer with a low false positive rate (one of the tests indicates that a person has cancer without cancer). At the time of this substudy registration, 5 of 580 samples from non-cancer patients (less than 1%) had similar cancer signals in all three tests. Of the five participants, two were subsequently diagnosed with cancer (one with stage III ovarian cancer and one with stage II endometrial cancer), highlighting the potential of such tests to identify early cancer. .

In lung cancer patients, the study found that more than 54% of somatic (non-genetic) mutations detected in blood samples were from white blood cells, not tumors. Dr. Oxnard pointed out that these mutations are likely to be the result of a natural aging process (so-called potentially indeterminate clone hematopoiesis or microarrays) that needs to be considered when developing blood tests for early detection of blood cancer.

Image source: NIH

02. Meaning

Liquid biopsies that analyze cell-free DNA in the blood have been used to help people who have been diagnosed with lung cancer to choose targeted therapy. Until recently, there was limited evidence that cell-free DNA analysis may contribute to early detection of disease.

Lead researcher Dr. Geoffrey Oxnard said: "We are very pleased that the preliminary results of the CCGA study show that early sequencing of lung cancer can be detected from blood samples using genome sequencing. Based on global demand for early detection of lung cancer has not been met, this test can be easily Medical system implementation. With these early results, the next step is to further optimize the analysis and validate the results in a larger population."

Currently, as part of the same substudy, the researchers are validating these results in an independent panel of approximately 1,000 participants from CCGA. Next, they will continue to optimize the tests and then validate them in the larger data set of CCGA. In addition, as the sample size increases, machine learning methods are expected to improve test performance.

References: 1) Early Detection of Lung Cancer Shows Promise in Liquid Biopsy Study

Source: Bio-Exploration

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