Association of personalized and tumor-informed ctDNA with patient survival outcomes in pancreatic adenocarcinoma

作者：Gregory P. Botta, Maen Abdelrahim, Ronald Drengler, Vasily N. Aushev, Abdullah Esmail, George Laliotis, Chris M. Brewer, Giby V. George, Steven Abbate, Sreenivasa R Chandana, Mohamedtaki Abdulaziz Tejani, Midhun Malla, Dhruv Bansal, Samuel Rivero-Hinojosa, Erik Spickard, Nicole McCormick, Michael Cecchini, Jill Lacy, Naomi Fei, Pashtoon Murtaza Kasi, Anup Kasi, Farshid Dayyani, Diana L. Hanna, Shruti Sharma, Meenakshi Malhotra, Alexey Aleshin, Minetta C. Liu, Adham Jurdi · 发表于：The Oncologist · 年份：2024 · DOI：10.1093/oncolo/oyae155 · 被引用次数：40 · 研究领域：Cancer Genomics and Diagnostics、Pancreatic and Hepatic Oncology Research、Single-cell and spatial transcriptomics

INTRODUCTION: Personalized and tumor-informed circulating tumor DNA (ctDNA) testing is feasible and allows for molecular residual disease (MRD) identification in patients with pancreatic ductal adenocarcinoma (PDAC). METHODS: In this retrospective analysis of commercial cases from multiple US institutions, personalized, tumor-informed, whole-exome sequenced, and germline-controlled ctDNA levels were quantified and analyzed in patients with PDAC. Plasma samples (n = 1329) from 298 clinically validated patients were collected at diagnosis, perioperatively (MRD-window; within 2-12 weeks after surgery, before therapy), and during surveillance (>12 weeks post-surgery if no ACT or starting 4 weeks post-ACT) from November 2019 to March 2023. RESULTS: Of the initially diagnosed patients with stages I-III PDAC who went for resection, the median follow-up time from surgery was 13 months (range 0.1-214). Positive ctDNA detection rates were 29% (29/100) and 29.6% (45/152) during the MRD and surveillance windows, respectively. Positive ctDNA detection was significantly associated with shorter DFS within the MRD window (median DFS of 6.37 months for ctDNA-positive vs 33.31 months for ctDNA-negative patients; HR: 5.45, P < .0001) as well as during the surveillance period (median DFS: 11.40 months for ctDNA-positive vs NR for ctDNA-negative; HR: 12.38, P < .0001). Additionally, DFS was significantly better with KRAS wildtype status followed by KRASG12R (HR: 0.99, P = .97), KRASG12D (HR: 1.42...