Liquid Biopsy for ALK-Positive Early Non-Small-Cell Lung Cancer Predicts Disease Relapse

Abstract

Background: We aimed to determine whethercirculating tumor cells (CTCs) and cell-free DNA (cfDNA) aids in prognosis of relapse-free survival (RFS). Methods: Non-small cell lung cancerpatients with ALK mutations were recruited prospectively. CTCs and cfDNA were quantified at different time points. RFS was estimated and correlated. Results: Baseline median CTCs and cfDNA were 16 cells and 57ng/mL and declined to ninecells and 30ng/mL, respectively, postsurgery in 150 patients. Interestingly, patients without detectable CTCs postsurgery fared better for RFS. cfDNA monitoring showed deviations within 7 months of surgery that were significant predictors for RFS. Conclusion: Short-term monitoring of CTCs and cfDNA variations shows promise for early risk detection and may aid in better disease control.

Lay abstract

Various treatment options are available for lung cancer. The challenge is monitoring disease relapse. We tested patients with specific mutations using liquid biopsyconsisting of tumor cells (CTCs) or cell-free DNA (cfDNA). In this study, we examined the benefit of these tests. The tests help us identify high-risk patients. Briefly, 150 patients were followed. Patients without detectable CTCs in blood after surgery showed better relapse-free survival. Trends in cfDNA within 7 months of surgery showed animpact on risk detection. Such testing helps recognize patients at higher risk for relapse. Short-term monitoring of CTCs and cfDNA in blood shows promise for early risk detection and may aid in better disease control.

Keywords::

• ALK
• cfDNA
• CTCs
• liquid biopsy
• NSCLC

Financial & competing interests disclosure

The authors gratefully acknowledge the research grants provided by Hainan Provincial Key Technology Program(ZDYF2018172), Hainan Natural Science Foundation Project(309083) and Hainan Provincial Health Department Fund for Science and Technology(1801320241A2001) for the investigative work for this study. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

The authors state that they obtained appropriate institutional review board approval or followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations. In addition, for investigations involving human subjects, informed consent was obtained from the participants involved.

Additional information

Funding

The authors gratefully acknowledge the research grants provided by Hainan Provincial Key Technology Program(ZDYF2018172), Hainan Natural Science Foundation Project(309083) and Hainan Provincial Health Department Fund for Science and Technology(1801320241A2001) for the investigative work for this study. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.