Rapid decrease of circulating tumor DNA predicted the treatment effect of nivolumab in a lung cancer patient within only 5 days

Respiratory Medicine Case Reports

卷:22

Seishi Higashi¹  Yosuke Hirotsu²  Kenji Amemiya²  Yuki Iijima³  Yoshihiro Miyashita³  Masao Omata⁴ 

[1] Department of Respirology, Hokuto City Shiokawa Hospital, 773, Fujita, Sutama-Town, Hokuto-City, Yamanashi, 408-0114, Japan;

[2] Genome Analysis Center, Yamanashi Prefectural Central Hospital, 1-1-1 Fujimi, Kofu-City, Yamanashi, 400-8506, Japan;

[3] Lung Cancer and Respiratory Disease Center, Yamanashi Prefectural Central Hospital, 1-1-1 Fujimi, Kofu-City, Yamanashi, 400-8506, Japan;

[4] The University of Tokyo, 7-3-1 Hongo, Bunkyou-ku, Tokyo, 113-8654, Japan;

关键词: Circulating tumor DNA;    Immune checkpoint therapy;    Nivolumab;    Lung cancer;    PD-1;   

DOI  :  10.1016/j.rmcr.2017.05.015

来源: DOAJ

【 摘 要 】

A 77-year-old Japanese man presented to our hospital with a 1-month history of low back pain and was diagnosed as having stage IV EGFR mutation-positive lung adenocarcinoma. After treatment with EGFR tyrosine kinase inhibitor and cytotoxic chemotherapy, nivolumab was started as fourth-line therapy. Remarkable regression of the primary tumor was observed, suggesting high anti-tumor activity of nivolumab. We retrospectively investigated the change in circulating tumor DNA (ctDNA) variant allele fractions in serial plasma samples before and after the nivolumab therapy. Targeted sequencing analysis showed tumor-derived TP53R249S and EGFRL858R mutations detectable in plasma, and the timing of decrease was only 5 days, much earlier than the appearance of radiological changes. Overall, these results suggest that ctDNA might reflect tumor burden and might be a surrogate marker of the therapeutic efficacy of immune checkpoint therapy.

【 授权许可】

Unknown