The following is a summary of “Tumor-informed fixed and patient-specific panels for minimal residual disease (MRD) detection in early-stage NSCLC: a head-to-head comparison,” published in the April 2023 issue of Oncology by Zhang, et al.
The recurrence of non-small cell lung cancer (NSCLC) may be predicted using ctDNA minimal residual disease (MRD) detection based on a tumor-informed or tumor-naive strategy. The fixed and patient-specific panels show promise in MRD monitoring as part of a tumor-informed strategy. In addition, somatic mutations in specific tissues can be tracked using a patient-specific panel. As a bonus, the fixed panel can help compensate for the shortfall from having a diverse workforce. Here, researchers compared the performance of innovative fixed and patient-specific panels in tumor monitoring.
There were a total of 81 patients evaluated, 45 (55.6%) of whom had stage I resected NSCLC, 15 (18.5%) had stage II resected NSCLC, and 21 (24.9%) had stage III resected NSCLC. Biopsies of the tumor were taken during the procedure. Blood samples before surgery (baseline) were evaluated using hybrid capture technology with fixed panels informed by tumor data and patient-specific panels. Ultra-deep (60000X) next-generation sequencing of a defined panel of 158 genes encompassing 118 kb of the human genome was used to inform tumor treatment decisions. In addition, whole-exome sequencing was used to identify 40 patient-specific SNVs, and an ultra-deep (100000X) next-generation sequencing panel was also done. About 212 mutations in tumors were tracked using a fixed panel (median, 3; range, 0-7). Most were found in their respective tumor tissues (95.3 %).
The detection of somatic tissue mutations affected 91% of patients using patient-specific panels with a tailored design containing 40 mutations. Baseline ctDNA mutation detection rates were 46.9% versus 49.4% (P=0.75), depending on whether the panel was fixed or patient-specific (Stage I: 35.6% versus 37.8%, P= 0.83; Stage II: 53.3% versus 60%, P=0.71; Stage III: 66.7% versus 66.7%). The presence of ctDNA in early-stage NSCLC can be detected using either a tumor-informed fixed or patient-specific panel NGS test. However, a patient-specific panel led to a greater incidence of ctDNA mutation detection before surgery