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Powles T, Young A, Nimeiri H, Madison RW, Fine A, Zollinger DR, Huang Y, Xu C, Gjoerup OV, Aushev VN, Wu HT, Aleshin A, Carter C, Davarpanah N, Degaonkar V, Gupta P, Mariathasan S, Schleifman E, Assaf ZJ, Oxnard G, Hegde PS. Molecular residual disease detection in resected, muscle-invasive urothelial cancer with a tissue-based comprehensive genomic profiling-informed personalized monitoring assay. Front Oncol 2023; 13:1221718. [PMID: 37601688 PMCID: PMC10433150 DOI: 10.3389/fonc.2023.1221718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 07/11/2023] [Indexed: 08/22/2023] Open
Abstract
Introduction Circulating tumor DNA (ctDNA) detection postoperatively may identify patients with urothelial cancer at a high risk of relapse. Pragmatic tools building off clinical tumor next-generation sequencing (NGS) platforms could have the potential to increase assay accessibility. Methods We evaluated the widely available Foundation Medicine comprehensive genomic profiling (CGP) platform as a source of variants for tracking of ctDNA when analyzing residual samples from IMvigor010 (ClinicalTrials.gov identifier NCT02450331), a randomized adjuvant study comparing atezolizumab with observation after bladder cancer surgery. Current methods often involve germline sampling, which is not always feasible or practical. Rather than performing white blood cell sequencing to filter germline and clonal hematopoiesis (CH) variants, we applied a bioinformatic approach to select tumor (non-germline/CH) variants for molecular residual disease detection. Tissue-informed personalized multiplex polymerase chain reaction-NGS assay was used to detect ctDNA postsurgically (Natera). Results Across 396 analyzed patients, prevalence of potentially actionable alterations was comparable with the expected prevalence in advanced disease (13% FGFR2/3, 20% PIK3CA, 13% ERBB2, and 37% with elevated tumor mutational burden ≥10 mutations/megabase). In the observation arm, 66 of the 184 (36%) ctDNA-positive patients had shorter disease-free survival [DFS; hazard ratio (HR) = 5.77; 95% confidence interval (CI), 3.84-8.67; P < 0.0001] and overall survival (OS; HR = 5.81; 95% CI, 3.41-9.91; P < 0.0001) compared with ctDNA-negative patients. ctDNA-positive patients had improved DFS and OS with atezolizumab compared with those in observation (DFS HR = 0.56; 95% CI, 0.38-0.83; P = 0.003; OS HR = 0.66; 95% CI, 0.42-1.05). Clinical sensitivity and specificity for detection of postsurgical recurrence were 58% (60/103) and 93% (75/81), respectively. Conclusion We present a personalized ctDNA monitoring assay utilizing tissue-based FoundationOne® CDx CGP, which is a pragmatic and potentially clinically scalable method that can detect low levels of residual ctDNA in patients with resected, muscle-invasive bladder cancer without germline sampling.
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Affiliation(s)
- Thomas Powles
- Barts Experimental Cancer Medicine Centre, Barts Cancer Institute, Queen Mary University of London ECMC, Barts Health, London, United Kingdom
| | - Amanda Young
- Foundation Medicine, Cambridge, MA, United States
| | | | | | | | | | - Yanmei Huang
- Foundation Medicine, Cambridge, MA, United States
| | - Chang Xu
- Foundation Medicine, Cambridge, MA, United States
| | | | | | | | | | - Corey Carter
- Roche/Genentech, South San Francisco, CA, United States
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Zhang L, Li X, Yang L, Tang Y, Guo J, Li D, Li S, Li Y, Wang L, Lei Y, Qiao H, Yang G, Wang X. Multi‐Sequence and Multi‐Regional
MRI
‐Based Radiomics Nomogram for the Preoperative Assessment of Muscle Invasion in Bladder Cancer. J Magn Reson Imaging 2022. [DOI: 10.1002/jmri.28498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 10/10/2022] [Accepted: 10/11/2022] [Indexed: 11/10/2022] Open
Affiliation(s)
- Lu Zhang
- College of Medical Imaging Shanxi Medical University Taiyuan China
| | - Xiaoyang Li
- College of Medical Imaging Shanxi Medical University Taiyuan China
| | - Li Yang
- College of Medical Imaging Shanxi Medical University Taiyuan China
| | - Ying Tang
- College of Medical Imaging Shanxi Medical University Taiyuan China
| | - Junting Guo
- College of Medical Imaging Shanxi Medical University Taiyuan China
| | - Ding Li
- College of Medical Imaging Shanxi Medical University Taiyuan China
| | - Shuo Li
- College of Medical Imaging Shanxi Medical University Taiyuan China
| | - Yan Li
- Department of Radiology The First Hospital of Shanxi Medical University Taiyuan China
| | - Le Wang
- Department of Radiology The First Hospital of Shanxi Medical University Taiyuan China
| | - Ying Lei
- Department of Radiology The First Hospital of Shanxi Medical University Taiyuan China
| | - Hong Qiao
- Department of Radiology The First Hospital of Shanxi Medical University Taiyuan China
| | - Guoqiang Yang
- Department of Radiology The First Hospital of Shanxi Medical University Taiyuan China
| | - Xiaochun Wang
- Department of Radiology The First Hospital of Shanxi Medical University Taiyuan China
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