Liquid biopsy may predict odds of survival among patients with metastatic cancer
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Liquid biopsy effectively predicted survival outcomes among a cohort of patients with various metastatic cancer types, according to study results published in Annals of Oncology.
Additional research is needed to confirm the findings, researchers wrote.
Background and methods
Genomic analysis of circulating tumor DNA (ctDNA) is commonly used for clinical management of patients with metastatic cancer, and ctDNA analysis has enabled calculation of circulating tumor fraction, which has been shown to be prognostic, according to study background.
“There are two reasons to look at anything analytically like this in a patient’s tumor,” Zachery Roger Reichert, MD, PhD, clinical associate professor in the department of medical oncology and internal medicine at University of Michigan Health Rogel Cancer Center, said in a press release. “One is it tells you what to do next. The other is it can help you counsel a patient on what to expect. In several cancers, we have multiple options for treatment without knowing which one is better for whom. A better understanding of the disease risk will help the patient and provider better balance the treatment risks.”
Researchers pooled data from a nationwide de-identified clinico-genomic database including 1,725 patients with metastatic castration-resistant prostate cancer (n = 198), metastatic breast cancer (n = 402), advanced non-small-cell lung cancer (n = 902) or metastatic colorectal cancer (n = 223). Patients underwent liquid biopsy testing as part of routine care.
Researchers estimated tumor fraction based on single-nucleotide polymorphism aneuploidy across the genome. They gathered clinical, disease, laboratory and treatment data from electronic health records, and evaluated OS by tumor fraction level while controlling for relevant covariables.
Findings
Results of univariable analyses showed an association between a tumor fraction of 10% or greater and OS for metastatic castration-resistant prostate cancer (HR = 3.3; 95% CI, 2.04-5.34), metastatic breast cancer (HR = 2.4; 95% CI, 1.71-3.37), advanced NSCLC (HR = 1.68; 95% CI, 1.34-2.1) and metastatic colorectal cancer (HR = 2.11; 95% CI, 1.39-3.2).
“We often end up falling back on the idea that a patient has ‘good’ disease or ‘bad’ disease — this rudimentary gut feeling, of which the accuracy is questionable,” Reichert said in the release. “That’s a lost opportunity for being able to counsel patients more effectively. Now for diseases when a liquid biopsy is offered as standard of care, it can provide some context that may not only be predictive for what to do, but also what to expect for results, and that’s something we can discuss with patients.”
Limitations of the study included the fact that it predominantly included observational evidence as its backbone and availability of tumor fraction served as an entry requirement, whereas other covariables in the multivariable models may have been missing, thus, creating a potential bias favoring tumor fraction, researchers noted.
Implications
Although more research is needed to confirm the findings, “the fact that the tests successfully predicted survival across all cancer types is encouraging,” Reichert said in the release. “The ability to counsel patients better and help people make the best shared decision for their next therapy could have a big impact.”
References:
- Blood tests could predict survival odds for patients with metastatic cancer (press release). Available at: https://www.sciencedaily.com/releases/2022/11/221130151555.htm. Published Nov. 30, 2022. Accessed Jan. 5, 2023.
- Reichert ZR, et al. Ann Oncol. 2023;doi:10.1016/j.annonc.2022.09.163.
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