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Bessa X, Vidal J, Balboa JC, Márquez C, Duenwald S, He Y, Raymond V, Faull I, Burón A, Álvarez-Urturi C, Castells X, Bellosillo B, Montagut C. High accuracy of a blood ctDNA-based multimodal test to detect colorectal cancer. Ann Oncol 2023; 34:1187-1193. [PMID: 37805131 DOI: 10.1016/j.annonc.2023.09.3113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 09/22/2023] [Accepted: 09/22/2023] [Indexed: 10/09/2023] Open
Abstract
BACKGROUND Detection of circulating tumor DNA (ctDNA) is a minimally invasive and convenient blood-based screening strategy that may increase effectiveness of colorectal cancer (CRC) screening. PATIENTS AND METHODS A novel multimodal ctDNA-based blood assay that integrates genomics, epigenomics and fragmentomics, as well as proteomics in a refined version, was tested in blood samples from two cohorts: (i) consecutive fecal immunochemical test (FIT)-positive individuals from the CRC Barcelona stool-based screening program; (ii) patients diagnosed with CRC. Primary endpoint was the performance of the test to detect CRC at different tumor-node-metastasis (TNM) stages. Secondary endpoint was the ability of the test to detect advanced precancerous lesions (advanced adenoma or advanced serrated lesion). RESULTS A total of 623 blood samples were analyzed in the primary analysis. Sensitivity and specificity of the assay to detect CRC was 93% and 90%, respectively. The sensitivity of CRC detection according to TNM stages was 84% for stage I, 94% for stage II and 96% for stage III (70/73) (P< 0.024). Sensitivity to detect advanced precancerous lesions was 23% with a refined version of the test (including protein and updating bioinformatic thresholding). CONCLUSION A blood-based multimodal ctDNA assay detected CRC with high accuracy. This minimally invasive, accessible and convenient assay may help to increase the effectiveness of CRC screening.
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Affiliation(s)
- X Bessa
- Gastroenterology Department, Hospital del Mar Research Institute, Barcelona.
| | - J Vidal
- Medical Oncology Department, Hospital del Mar Research Institute, CIBERONC, Barcelona, Spain
| | - J C Balboa
- Gastroenterology Department, Hospital del Mar Research Institute, Barcelona
| | - C Márquez
- Gastroenterology Department, Hospital del Mar Research Institute, Barcelona
| | | | - Y He
- Guardant Health Inc., Redwood City, USA
| | - V Raymond
- Guardant Health Inc., Redwood City, USA
| | - I Faull
- Guardant Health Inc., Redwood City, USA
| | - A Burón
- Epidemiology and Evaluation Department, Hospital del Mar Medical Research Institute, Barcelona, Spain; RICAPPS (Research Network on Chronicity, Primary Care and Prevention and Health Promotion), Madrid, Spain
| | - C Álvarez-Urturi
- Gastroenterology Department, Hospital del Mar Research Institute, Barcelona
| | - X Castells
- Epidemiology and Evaluation Department, Hospital del Mar Medical Research Institute, Barcelona, Spain; RICAPPS (Research Network on Chronicity, Primary Care and Prevention and Health Promotion), Madrid, Spain
| | - B Bellosillo
- Pathology Department, Hospital del Mar Medical Research Institute, CIBERONC, Barcelona, Spain
| | - C Montagut
- Medical Oncology Department, Hospital del Mar Research Institute, CIBERONC, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain.
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Mezquita L, Bucheit L, Laguna J, Pastor B, Teixido C, Gorria T, Albarran-Artahona V, Garcia de Herreros M, Reyes R, Reguart N, Viñolas N, Arcocha A, Puig-Butille J, Drusbosky L, Faull I, Auclin E, Castro E, Patel J, Prat A, Besse B. MA07.07 Clinical/Molecular Profile of Patients with Non-small Cell Lung Cancer (NSCLC) with Incidental Pathogenic Germline Variants Detected in cfDNA. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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3
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Benavides M, Alcaide-Garcia J, Torres E, Gil-Calle S, Sevilla I, Wolman R, Durán G, Álvarez M, Reyna-Fortes C, Ales I, Pereda T, Robles M, Kushnir M, Odegaard J, Faull I, Alba E. Clinical utility of comprehensive circulating tumor DNA genotyping compared with standard of care tissue testing in patients with newly diagnosed metastatic colorectal cancer. ESMO Open 2022; 7:100481. [PMID: 35525184 PMCID: PMC9271474 DOI: 10.1016/j.esmoop.2022.100481] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 03/21/2022] [Accepted: 03/23/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Comprehensive biomarker testing is essential in selecting optimal treatment for patients with metastatic colorectal cancer (mCRC); however, incomplete genotyping is widespread, with most patients not receiving testing for all guideline-recommended biomarkers, in part due to reliance on burdensome sequential tissue-based single-biomarker tests with long waiting times or availability of only archival tissue samples. We aimed to demonstrate that liquid biopsy, associated with rapid turnaround time (TAT) and lower patient burden, effectively identifies guideline-recommended biomarkers in mCRC relative to standard of care (SOC) tissue testing. PATIENTS AND METHODS Prospectively enrolled patients with previously untreated mCRC undergoing physician discretion SOC tissue genotyping submitted pretreatment blood samples for comprehensive circulating tumor DNA (ctDNA) analysis with Guardant360 and targeted RAS and BRAF analysis with OncoBEAM. RESULTS Among 155 patients, physician discretion SOC tissue genotyping identified a guideline-recommended biomarker in 82 patients, versus 88 identified with comprehensive ctDNA (52.9% versus 56.8%, noninferiority demonstrated down to α = 0.005) and 69 identified with targeted PCR ctDNA analysis (52.9% versus 44.5%, noninferiority rejected at α = 0.05). Utilizing ctDNA in addition to tissue increased patient identification for a guideline-recommended biomarker by 19.5% by rescuing those without tissue results either due to tissue insufficiency, test failure, or false negatives. ctDNA median TAT was significantly faster than tissue testing when the complete process from sample acquisition to results was considered (median 10 versus 27 days, P < 0.0001), resulting in accelerated biomarker discovery, with 52.0% biomarker-positive patients identified by ctDNA versus 10.2% by SOC tissue 10 days after sample collection (P < 0.0001). CONCLUSIONS Comprehensive ctDNA genotyping accurately identifies guideline-recommended biomarkers in patients with mCRC at a rate at least as high as SOC tissue genotyping, in a much shorter time. Based on these findings, the addition of ctDNA genotyping to clinical practice has significant potential to improve the care of patients with mCRC.
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Affiliation(s)
- M Benavides
- Medical Oncology Intercenter Unit, Hospital Universitario Regional y Virgen de la Victoria, IBIMA, Málaga, Spain
| | - J Alcaide-Garcia
- Medical Oncology Intercenter Unit, Hospital Universitario Regional y Virgen de la Victoria, IBIMA, Málaga, Spain; Medical Oncology Department, Hospital Costa del Sol, IBIMA, Málaga, Spain.
| | - E Torres
- Medical Oncology Intercenter Unit, Hospital Universitario Regional y Virgen de la Victoria, IBIMA, Málaga, Spain
| | - S Gil-Calle
- Medical Oncology Intercenter Unit, Hospital Universitario Regional y Virgen de la Victoria, IBIMA, Málaga, Spain
| | - I Sevilla
- Medical Oncology Intercenter Unit, Hospital Universitario Regional y Virgen de la Victoria, IBIMA, Málaga, Spain
| | - R Wolman
- Medical Oncology Service, Hospital Xanit, Málaga, Spain
| | - G Durán
- Medical Oncology Intercenter Unit, Hospital Universitario Regional y Virgen de la Victoria, IBIMA, Málaga, Spain; Medical Oncology Department, Hospital Universitario San Cecilio, Granada, Spain
| | - M Álvarez
- Cancer Molecular Biology Laboratory (CIMES), University of Málaga, Málaga, Spain
| | - C Reyna-Fortes
- Medical Oncology Intercenter Unit, Hospital Universitario Regional y Virgen de la Victoria, IBIMA, Málaga, Spain
| | - I Ales
- Medical Oncology Intercenter Unit, Hospital Universitario Regional y Virgen de la Victoria, IBIMA, Málaga, Spain
| | - T Pereda
- Pathology Department, Hospital Costa del Sol, IBIMA, Marbella, Spain
| | - M Robles
- Medical Oncology Department, Hospital Costa del Sol, Marbella, Spain
| | | | | | - I Faull
- Guardant Health Inc, Redwood, USA
| | - E Alba
- Medical Oncology Intercenter Unit, Hospital Universitario Regional y Virgen de la Victoria, IBIMA, CIBERONC, Málaga, Spain
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Martinez Saez O, Felip Falgas E, Cappelletti M, Tolosa P, Brasó-Maristany F, Sanfeliu Torres E, Pascual T, Chic N, Vidal M, Adamo B, Munoz M, Faull I, Odegaard J, Patel G, McEwen R, Carroll D, Ciruelos E, Generali D, Margeli Vila M, Prat A. 10P Survival according to early ctDNA dynamics in advanced breast cancer (ABC) treated with endocrine therapy (ET) and a CDK4/6 inhibitor (CDK4/6i). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.03.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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5
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Benavides M, Alcaide-Garcia J, Torres E, Gil S, Durán G, Reyna C, Wolman R, Alvarez M, Kushnir M, Faull I, Muñoz M, Alba E. 503P Mutational landscape in synchronous unresectable metastatic colorectal cancer (mCRC) according to upfront primary tumour resection (UPTR). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Garcia-Corbacho J, Victoria Ruiz I, Angelats L, Indacochea A, Martínez-Vidal J, Sole Bentz P, Moreno D, Faull I, Campillo M, Muñoz S, Saurí T, Reguart Aransay N, Viñolas N, Esposito F, Mezquita L, Basté N, Oliveres H, Castillo S, Nogué M, Prat A. 92P First-results of the CLIMB360 study, a prospective molecular screening program across multiple cancer types based on circulating tumor DNA (ctDNA). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Kingston B, Cutts R, Beaney M, Walsh-Crestani G, Hrebien S, Kilburn L, Kernaghan S, Moretti L, Wilkinson K, MacPherson I, Baird R, Roylance R, Reis-Filho J, Hubank M, Faull I, Banks K, Garcia-Murillas I, Bliss J, Ring A, Turner N. 99P Analysis of ctDNA in advanced breast cancer reveals polyclonal disease associated with adverse outcome. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.03.214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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8
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Cui W, Milner-Watts C, Lyons H, Yousaf N, Minchom A, Bhosle J, Davidson M, Scott S, Faull I, Nagy R, O'Brien M, Popat S. 163P Circulating tumour (ct) DNA next generation sequencing (NGS) in UK advanced non-small cell lung cancer (aNSCLC) patients (pts). J Thorac Oncol 2021. [DOI: 10.1016/s1556-0864(21)02005-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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9
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Cui W, Milner-Watts C, Faull I, Nagy R, Scott S, Minchom A, Bhosle J, Yousaf N, O'Brien M, Popat S. 1352P Circulating tumour (ct) DNA next generation sequencing (NGS) in advanced non-small cell lung cancer (mNSCLC): A UK single institution experience. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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10
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Martínez-Sáez O, Pascual T, Brasó-Maristany F, Chic N, González-Farré B, Sanfeliu E, Rodríguez A, Martínez D, Galván P, Rodriguez Hernandez A, Schettini F, Conte B, Vidal M, Adamo B, Muñoz M, Moreno R, Ciruelos E, Faull I, Odegaard J, Prat A. 5P Circulating tumour DNA (ctDNA) dynamics using a standardized multi-gene panel in advanced breast cancer patients (pts) treated with CDK4/6 inhibitors (CDK4/6i). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.03.141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Kushnir M, Winter H, Murias C, Bains P, Abbosh C, Papadatos-Pastos D, Newsome-Davis T, Ahmed T, Swanton C, Forster M, Moore D, Bennett P, Faull I, Lanman R, Arkenau HT. Cell-free circulating tumour DNA (ctDNA) in the management of patients with non-biopsiable advanced non-small cell lung cancer (NSCLC). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy292.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Palmero R, Taus A, Viteri S, Majem M, Carcereny E, Garde-Noguera J, Felip E, Sampayo M, Gomez L, Lopez N, Olsen S, Jackson M, Faull I, Dix D, Karachaliou N, Rosell R. P2.03-02 Cell-Free DNA (cfDNA) Testing in Lung Adenocarcinoma (LUAC) Patients: Spanish Lung Liquid Versus Invasive Biopsy Program (SLLIP). J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1189] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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13
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Winter H, Faull I, Bains P, Murias C, Kushnir M, Forster M, Kulkarni A, Moore D, Swanton C, Shiu K, Arkenau HT. Circulating tumour DNA experience in patients with cancer of unknown primary. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy269.150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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14
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Karachaliou N, Lefterova M, Draper J, Molina MA, Chaib I, Palmero R, Taus A, Viteri S, González Cao M, Majem Tarruella M, Carcereny Costa E, Moran T, Garde Noguera J, Felip Font E, Olsen S, Jackson M, Sampayo M, Faull I, Dix D, Rosell R. Homology-directed repair (HDR)-defective lung adenocarcinomas (LUACs) in circulating tumor DNA (ctDNA). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy304.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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15
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Pérez L, Saiz López P, Sánchez-Escribano R, Rodrigo A, García González M, Durán M, Infante M, Terradez A, Faull I, Lastra E. Application of liquid biopsies in metastatic gastrointestinal cancer to identify candidate therapeutic targets. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy316] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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16
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Uccello M, Kushnir M, Mak G, Murias Henriquez C, Abbosh C, Papadatos-Pastos D, Newsom-Davis T, Ahmad T, Swanton C, Forster M, Lanman R, Faull I, Arkenau HT. Circulating tumour DNA (ctDNA) in the clinical management of patients (pts) with advanced non-small cell lung cancer (NSCLC): A single centre experience. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx363.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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17
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Albanell J, González A, Ruiz-Borrego M, Alba E, García-Saenz JA, Corominas JM, Burgues O, Furio V, Rojo A, Palacios J, Bermejo B, Martínez-García M, Limon ML, Muñoz AS, Martín M, Tusquets I, Rojo F, Colomer R, Faull I, Lluch A. Prospective transGEICAM study of the impact of the 21-gene Recurrence Score assay and traditional clinicopathological factors on adjuvant clinical decision making in women with estrogen receptor-positive (ER+) node-negative breast cancer. Ann Oncol 2012; 23:625-631. [PMID: 21652577 DOI: 10.1093/annonc/mdr278] [Citation(s) in RCA: 96] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND This study examined the impact of the Recurrence Score (RS) in Spanish breast cancer patients and explored the associations between clinicopathological markers and likelihood of change in treatment recommendations. PATIENTS AND METHODS Enrollment was offered consecutively to eligible women with estrogen receptor-positive; human epidermal growth factor receptor 2-negative, node-negative breast cancer. Oncologists recorded treatment recommendation and confidence in it before and after knowing the patient's RS. RESULTS Treatment recommendation changed in 32% of 107 patients enrolled: in 21% from chemohormonal (CHT) to hormonal therapy (HT) and in 11% from HT to CHT. RS was associated with the likelihood of change from HT to CHT (P < 0.001) and from CHT to HT (P < 0.001). Confidence of oncologists in treatment recommendations increased for 60% of cases. Higher tumor grade (P = 0.007) and a high proliferative index (Ki-67) (P = 0.023) were significantly associated with a greater chance of changing from HT to CHT, while positive progesterone receptor status (P = 0.002) with a greater probability of changing from CHT to HT. CONCLUSIONS Results from the first prospective European study are consistent with published experience and use of the RS as proposed in European clinical practice guidelines and provide evidence on how Oncotype DX and clinicopathological factors are complementary and patient selection may be improved.
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Affiliation(s)
- J Albanell
- Medical Oncology Service, Hospital del Mar, Barcelona; Cancer Research Program, IMIM (Hospital del Mar Research Institute), Barcelona; Department of Medicine, Autonomous University of Barcelona, Barcelona.
| | - A González
- Medical Oncology Service, MD Anderson, Madrid
| | - M Ruiz-Borrego
- Medical Oncology Service, Hospital Virgen del Rocío, Sevilla
| | - E Alba
- Medical Oncology Service, Hospital Virgen de la Victoria, Málaga
| | | | - J M Corominas
- Cancer Research Program, IMIM (Hospital del Mar Research Institute), Barcelona; Department of Medicine, Autonomous University of Barcelona, Barcelona; Pathology Service, Hospital del Mar, Barcelona
| | - O Burgues
- Pathology Service, Hospital Clínico, Valencia
| | - V Furio
- Pathology Service, Hospital Clínico, Madrid
| | - A Rojo
- Pathology Service, MD Anderson, Madrid
| | - J Palacios
- Pathology Service, Hospital Virgen del Rocío, Sevilla
| | - B Bermejo
- Department of Hematology and Oncology, Hospital Clínico de Valencia, Valencia
| | - M Martínez-García
- Medical Oncology Service, Hospital del Mar, Barcelona; Cancer Research Program, IMIM (Hospital del Mar Research Institute), Barcelona
| | - M L Limon
- Medical Oncology Service, Hospital Virgen del Rocío, Sevilla
| | - A S Muñoz
- Medical Oncology Service, Hospital Virgen de la Victoria, Málaga
| | - M Martín
- Medical Oncology Service, Hospital Gregorio Marañón Madrid, Madrid
| | - I Tusquets
- Medical Oncology Service, Hospital del Mar, Barcelona; Cancer Research Program, IMIM (Hospital del Mar Research Institute), Barcelona
| | - F Rojo
- Cancer Research Program, IMIM (Hospital del Mar Research Institute), Barcelona; Pathology Service, Fundación Jiménez Díaz, Madrid
| | - R Colomer
- Medical Oncology Service, MD Anderson, Madrid
| | | | - A Lluch
- Department of Hematology and Oncology, Hospital Clínico de Valencia, Valencia
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