DYNAMIC trial data spark Twitter talk about ‘future of patient risk stratification’
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The potential for ctDNA-guided management to reduce adjuvant chemotherapy by half without compromising recurrence-free survival sparked interest on social media after a presentation at the ASCO Annual Meeting.
Fresh off a presentation by Jeanne Tie, MD, MBChB, FRACP, on the DYNAMIC trial, Healio and Creation Healthcare, a digital insights company, analyzed health care provider sentiments on the results.
Paolo Tarantino, MD (@PTarantinoMD). June 4, 2022. The MRD revolution has started. In this trial (n=455), stage II CRC pts were randomized to standard management or ctDNA-guided (no adj chemo if ctDNA negative). ctDNA guidance halved the use of chemotherapy, preserving outcomes. We need the same in #bcsm! [Image in original post.] Twitter.
In the trial, Tie and colleagues evaluated whether ctDNA-guided treatment could spare certain patients unnecessary adjuvant chemotherapy without affecting recurrence risk in 455 patients with resected stage II colon cancer.
As Healio reported previously, overall, 15.3% of patients assigned to ctDNA-based treatment received adjuvant chemotherapy vs. 27.9% of those randomized to physician guided treatment (OR = 2.14; P = .002). Moreover, the researchers reported 3-year RFS rates of 86.4% after adjuvant chemotherapy use among ctDNA-positive patients and, among ctDNA-negative patients, 92.5% without adjuvant chemotherapy and 96.7% in a subgroup of patients with low clinical risk.
Clinicians commended the study for its potential implications in the future of patient risk stratification and adjuvant chemotherapy optimization.
Yakup Ergun (@dr_yakupergun) June 4, 2022. DYNAMIC study now published on @NEJM: Circulating Tumor DNA Analysis Guiding Adjuvant Therapy in Stage II Colon Cancer. ctDNA guides patient selection in the adjuvant treatment of stage 2 colon cancer without compromising survival #ASCO22 @OncoAlert [Image in original post.] Twitter.
with standard management.
Jun Gong (@jgong15). June 4, 2022. Stage II post-op #crcsm #ctDNA DYNAMIC trial, beginning of prospective data we’ve waited for: substantially reduced adjuvant chemo by nearly 50% w/o compromising 2-yr RFS in ctDNA-guided approach vs. SOC (40% high-risk St II in both) #ASCO22 same-day NEJM https://nejm.org/doi/full/10.10... [Images in original post.] Twitter.
On the day the data were announced, the link to the NEJM publication was shared in 331 social media posts, including 157 from health care practitioners. This made it the most shared page in social media posts about ASCO on June 4.
Some health care practitioners praised the trial and its methodology.
Roberto Pestana, MD (@PestanaRC) June 4, 2022, #ASCO22 Results of the DYNAMIC study, concomitantly published @NEJM Incredible, practice-informing data. ctDNA-guided adjuvant therapy in this phase II data was non-inferior to standard management, and lead [sic] to less patients receiving chemotherapy. [Images in original post.] Twitter.
Jon Mizrahi (@jonmizrahi). June 4, 2022. The future of adjuvant therapy decision making in stage II colon cancer? ctDNA. Results of DYNAMIC study. Fewer patients received chemo in ctDNA guided arm than standard arm. Recurrence free survival appears just as good. #ASCO22 #CRCSM [Image In original post.] Twitter.
There was also comment that research looked at de-escalation of adjuvant chemotherapy for stage II CRC rather than evaluation of escalation strategies.
Filip Janku (@FilipJankuMD). June 4, 2022. ctDNA is advancing to the adjuvant setting at @ASCO and @NEJM. DYNAMIC tested ctDNA guided vs. standard approach in stage II CRC. Very interesting. I thought escalation strategies would be tested first before de-escalation strategies #ASCO22 [Image in original post.] Twitter.
One poster responded to Janku’s tweet.
@NYCDoc29. June 4, 2022. if it meant expensive, branded, on patent medication I wouldn’t have been surprised! Twitter.
The potential to improve the precision of patient selection in stage II CRC treatment while minimizing unnecessary adjuvant chemotherapy generated near-unanimous enthusiasm for the future direction of this research.
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Creation Healthcare is a specialist digital insights consultancy providing research and analysis to inform health strategy, communications and policymaking among some of the world’s largest health care companies, government organizations and non-government organizations.
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Tie J, et al. Abstract LBA100. Presented at: ASCO Annual Meeting; June 3-7, 2022; Chicago.
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