Residual ctDNA after treatment predicts early relapse in patients with early-stage non-small cell lung cancer

BACKGROUND

Identification of residual disease in patients with localized non-small cell lung cancer (NSCLC) following treatment with curative intent holds promise to identify patients at risk of relapse. New methods can detect circulating tumour DNA (ctDNA) in plasma to fractional concentrations as low as a few parts per million, and clinical evidence is required to inform their use.

PATIENTS AND METHODS

We analyzed 363 serial plasma samples from 88 patients with early-stage NSCLC (48.9%/28.4%/22.7% at stage I/II/III), predominantly adenocarcinomas (62.5%), treated with curative intent by surgery (n = 61), surgery and adjuvant chemotherapy/radiotherapy (n = 8), or chemoradiotherapy (n = 19). Tumour exome sequencing identified somatic mutations and plasma was analyzed using patient-specific RaDaR™ assays with up to 48 amplicons targeting tumour-specific variants unique to each patient.

RESULTS

ctDNA was detected before treatment in 24%, 77% and 87% of patients with stage I, II and III disease, respectively, and in 26% of all longitudinal samples. The median tumour fraction detected was 0.042%, with 63% of samples <0.1% and 36% of samples <0.01%. ctDNA detection had clinical specificity >98.5% and preceded clinical detection of recurrence of the primary tumour by a median of 212.5 days. ctDNA was detected after treatment in 18/28 (64.3%) of patients who had clinical recurrence of their primary tumour. Detection within the landmark timepoint 2 weeks to 4 months after treatment end occurred in 17% of patients, and was associated with shorter recurrence-free survival [hazard ratio (HR): 14.8, P <0.00001] and overall survival (HR: 5.48, P <0.0003). ctDNA was detected 1-3 days after surgery in 25% of patients yet was not associated with disease recurrence. Detection before treatment was associated with shorter overall survival and recurrence-free survival (HR: 2.97 and 3.14, P values 0.01 and 0.003, respectively).

CONCLUSIONS

ctDNA detection after initial treatment of patients with early-stage NSCLC using sensitive patient-specific assays has potential to identify patients who may benefit from further therapeutic intervention.

Numérique, virtuel, réseaux sociaux, objets connectés : leviers ou freins à la confiance dans la relation de soins ?

Le numérique doit faciliter la vie des usagers ainsi que des professionnels. Il peut être un levier de promotion de la santé, de réduction des inégalités et de renforcement de la confiance dans la relation de soins. Mais c’est à condition que certains préalables soient assurés :

- le numérique ne se substitue pas aux professionnels de santé ;

- derrière l’outil, il y aura toujours une intervention humaine ;

- en cas de difficultés, des interventions en présentiel seront toujours prévues ;

- le numérique s’attache à respecter les droits des usagers tels qu’énoncés par la loi (confidentialité, sécurité des données, etc.) ;

- le numérique doit viser la réponse aux besoins de l’ensemble des usagers (principe d’égalité).

Regio- and stereoselective intermolecular carbolithiation reactions

Carbolithiation of alkenes provides a powerful tool for the construction of up to two novel carbon–carbon or carbon–heteroatoms bonds in a regio- and stereo-controlled manner. The synthetic potentiality of this reaction is highlighted.

Effects of legume seeds and processing treatment on growth, carcass traits and blood constituents of fattening lambs

This study aimed to evaluate the effects of faba bean, white lupin and pea seed when fed as protein supplements on growth performance, carcass characteristics and haematological characteristics of growing lambs. Forty-eight Gentile di Puglia male lambs, weaned at 38 ± 2 days old with an average initial bodyweight of 12.8 ± 0.5 kg, were divided into six homogenous groups. The six dietary treatments were RFB (diet containing raw faba bean seeds); EFB (diet containing extruded faba bean seeds); RL (diet containing raw lupin seeds); EL (diet containing extruded lupin seeds); RP (diet containing raw pea seeds); and EP (diet containing extruded pea seeds). Feeding lupin seeds reduced average daily feed intake compared with the other protein sources. Carcass conformation, loin weight as a percentage of half-carcass weight, and fat weight as a percentage of loin weight improved in the lambs that consumed both EP and RP diets. Extrusion reduced hide weight as a percentage of empty bodyweight and fat weight as a percentage of leg weight. The protein source had a significant effect on glucose and total cholesterol concentrations, albumin, α1-globulin, β-globulin, and γ-globulin percentages and albumin-globulin ratios. The processing treatment decreased total cholesterol concentrations. Thus, feeding the various legumes did not affect growth performance, but only carcass characteristics; changes which may be due to the differences in feed intake. Extrusion also had minor effects, and further work is required to investigate the use of these protein sources, both raw and extruded.Keywords: extrusion, faba bean, haematology, lupin, pea, protein source, slaughter data

Influence of Feeds and Rearing System on the Productive Performances and the Chemical and Fatty Acid Composition of Hare Meat

Hare meat from animals differently reared and fed were analysed to compare the influence of different rearing techniques, different energy levels of feeds and gender on the productive performances of hares, and on the quantitative characteristics and chemical and fatty acid profile of the meat. The effects of diet and gender did not produce important differences in productive performances and on the quantitative and qualitative parameters under consideration. Statistically significant differences were found depending on rearing techniques. Those differences for the hares reared in cages referred to better productive performances which favoured fleshier carcasses and a higher accumulation of fat. The acid composition depended on the rearing conditions, which affected the motor activity of the animals and therefore the consumption and the deposit of determined lipid fractions.

Effects of protein sources on performance, carcass composition, blood parameters and meat quality in Charolais heifers

The aim of the present study was to evaluate the effects of feeding faba bean and sweet lupin as alternative protein sources to soybean on productive performance, blood parameters, carcass composition, and chemical-physical characteristics of meat and its fatty acid (FA) profile in Charolais heifers. Twenty-four heifers were divided into three homogenous groups and fed with durum wheat straw and three iso-energetic and isonitrogenous pelleted complete diets containing 14% (on as-fed basis) soybean meal; 28% faba bean; and 20% sweet lupin seed. The animals were slaughtered after a 168 day feeding period, and the Longissimus lumborum muscle was sampled for meat quality measurements. The feed conversion index was better in the heifers fed faba bean compared with the soybean treatment group (6.71 versus 7.17). No differences were found among treatment groups in productive performance, slaughtering data and physical features. The concentration of linoleic acid in the meat of the soybean group differed significantly from that in the lupin group (2.38 versus 2.11%). Feeding lupin seed increased the concentrations of C20:3 n-6 (0.09%) and C20:4 n-6 (0.20%) in meat significantly, compared with the soya- and faba bean treatments (0.06–0.07% and 0.12–0.13%, respectively). No differences were found among groups for blood parameters, except for urea concentration, which was lower in the lupin group compared with the concentrations in the serum of heifers receiving the soya bean treatment (31.29 as opposed to 37.56 mg/dL). In conclusion, since faba bean and lupin seed did not affect any of the parameters negatively, these legume grains can be included successfully as alternative protein sources in beef cattle diet.Keywords: Faba bean, lupin seed, soybean, beef cattle, feeding