Circulating tumor DNA analysis is an emerging tool in cancer diagnosis and precision medicine
PITTSBURGH, Dec. 12, 2023 /PRNewswire-PRWeb/ -- When cancer cells die and disintegrate, they shed stray bits of DNA into the bloodstream. A new study by cancer specialists at Allegheny Health Network (AHN) and Johns Hopkins Medicine confirms that by sampling this "circulating tumor DNA" and other materials in the blood, doctors can better predict which immunotherapies might work best on a patient's lung cancer – and which ones might cause immune-related adverse events.
"For the last several years, immunotherapies have been transforming the way we treat non-small cell lung cancers," said Ali H. Zaidi, MD, Medical Director of Aerodigestive Research at the Allegheny Health Network Cancer Institute. "But immunotherapies aren't the optimal choice for every patient because some patients might not respond or be more prone than others to adverse reactions to the therapies, such as organ inflammation. Knowing more about the tumor's molecular makeup in advance of immunotherapy can aid clinical decision-making and will lead to improved lung cancer treatment regimens."
Additionally, the research article said that blood tests that monitor the patient's immune repertoire – that is, the specific genetic arrangements found within the patient's T-cell receptors – help doctors to better understand the patient's adaptive immune system, and how it will respond to an immunotherapy. Together, these "liquid biopsies" and other samples can identify a wide range of biomolecular cancer and immune system features, and as the blood tests become more sensitive, they can lead to more optimal cancer care and immunotherapies.
Immunotherapies treat diseases – typically, cancers – by activating or suppressing the immune system using certain vaccines, antibodies, or synthetic products. When activated properly, the adaptive immune system can be trained to destroy cancer cells.
"This is the future of cancer medicine – therapy regimens that are designed to match the cancer's genetic profile and the patient's immune system," said Dr. Zaidi. "At the AHN Cancer Institute, we are committed to testing and developing tomorrow's therapies, leading to more precise care and better outcomes for patients challenged by lung cancer."
Lung cancer is the leading cause of cancer death for both men and women in the United States. Non-small cell lung cancer (NSCLC) is the most common type of lung cancer and grows more slowly than small cell lung cancer. Because small-cell cancer has often spread to the lymph nodes and elsewhere in the body by the time it's discovered, it's typically first treated by chemotherapy and radiation therapy.
NSCLC, meanwhile, because it's typically confined to the lungs, is often a better candidate for surgical intervention, targeted therapy, and immunotherapy – if the cancer has the right mutations and biomarkers.
Historically, tissue biopsy is the gold standard for tumor assessment and diagnosis. However, there are risks associated with invasive sampling, particularly when it comes to fragile organs such as the lungs or brain.
But the advent of liquid biopsies – which capture circulating tumor DNA and other pertinent immune-system information – has made it easier to learn about a cancer's genetic characteristics, to learn if a cancer has spread, or to detect important genetic alterations in the cancer. Liquid biopsies also usually have quicker turnaround times than tissue biopsies, allowing treatment to start more quickly.
"AHN has been using liquid biopsies for years to learn more about non-small cell lung cancer," said David Bartlett, MD, Chair of the Allegheny Health Network Cancer Institute. "This paper confirms that the right blood tests, combined with the right analysis, can guide clinical decision-making and help doctors better predict clinical response to immunotherapy in lung cancer."
The article was published in November in the American Association for Cancer Research clinical journal. Among the co-authors are David Bartlett, MD (chair of the AHN Cancer Institute), Benny Weksler, MD (system director of Thoracic Surgery at AHN), Nathan Bahary, MD (academic chief of Medical Oncology at AHN), and co-corresponding author Ali H. Zaidi, MD (medical director of Aerodigestive Research at the AHN Cancer Institute).
Dr. Zaidi was one of the paper's co-senior/corresponding authors; researchers from Johns Hopkins Medicine, the Johns Hopkins School of Medicine, AHN, and the Sidney Kimmel Comprehensive Cancer Center also co-wrote the paper. Additionally, researchers from the Netherlands Cancer Institute, the Beaumont RCSI Cancer Centre in Ireland, and the California Institute of Technology participated in the study. The paper was supported, in part, by grants from the U.S. National Institutes of Health, and utilized blood samples from 49 AHN patients with advanced-stage (III or IV) non-small cell lung cancer.
These patient samples were provided from AHNCI Moonshot, the largest clinically annotated pan cancer biorepository in western Pennsylvania.
Media Contact
Emily Beatty, Allegheny Health Network, 5136789620, [email protected], www.ahn.org
SOURCE Allegheny Health Network
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