Health Technologies

Tumour DNA in the blood can predict lung cancer outcome, study finds

A test to detect circulating tumour DNA can predict lung cancer outcomes, a team of UK researchers has found.

The finding could lead to more personalised treatments for lung cancer.

James Black is Postdoctoral Clinical Fellow at the Francis Crick Institute and the CRUK Lung Cancer Centre of Excellence at UCL.

The researcher said: “We’ve shown that the presence or absence of tumour DNA in the blood was strongly predictive of prognosis. ctDNA testing, especially using ultrasensitive platforms, could help clinicians make more informed decisions about treatment and give patients a more accurate idea of how their disease might progress.

“More research to validate these tests will help to get them on the agenda for regular clinical use.”

Circulating tumour DNA (ctDNA) is fragments of DNA released into the blood by tumours.

It’s known to be important for disease prognosis but can be difficult to measure precisely.

Inthe new research, researchers at the Francis Crick Institute and UCL worked with Personalis to test a platform called NeXT Personal, which can detect very small amounts – 1 part per million – of ctDNA. T

his builds on the Crick team’s discovery of signals in the blood that detect cancer cells after treatment, which could indicate a potential for relapse.

They applied the platform to blood plasma samples from 171 people with early-stage lung cancer in the TRACERx cohort, finding that people with a low level of ctDNA before surgery were less likely to relapse and had improved overall survival rates than people with a high level of ctDNA.

The high sensitivity of the test meant that smaller amounts of ctDNA could be detected, which prevented people with a lower amount of ctDNA from being incorrectly labelled ctDNA negative2.

Early-stage lung cancer is usually treated by removing the tumour by surgery and with chemotherapy or immunotherapy, depending on the stage of the tumour, which aims to achieve the highest chance of cure.

The test will next be assessed on samples from patients that have undergone surgery with the earliest stages of lung cancer, to evaluate if the presence of ctDNA post-operatively in blood can be used to infer future risk of relapse.

This could allow doctors to offer additional therapy after surgery, increasing the chance of curing patients.

Marianne Baker is Research Information Manager at Cancer Research UK.

Baker said: “TRACERx is our flagship lung cancer research study, tracking the disease’s evolution over time.

“As a hard-to-treat cancer, the more we understand about its progression, the better equipped we are to beat it.

“The kind of test used in NeXT Personal can help us move toward an age of personalised medicine, ensuring clinicians can get the right treatment to the right people by accurately sorting them into groups based on what their disease is likely to do.

“The test can help to improve quality of life and survival by ensuring clinicians can go all-in for people whose disease is more likely to come back after treatment, while sparing people difficult treatments they might not need if their disease is less risky.

“More research is needed, but the study takes us a step closer to a day where treatments can be tailored to patients.

“The next chapter in TRACERx, TRACERx EVO, is now recruiting people to join the study and will be looking even deeper into the biology of lung cancer.”

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