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Supplementary Data from Longitudinal Undetectable Molecular Residual Disease Defines Potentially Cured Population in Localized Non–Small Cell Lung Cancer

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posted on 2023-04-04, 00:00 authored by Jia-Tao Zhang, Si-Yang Liu, Wei Gao, Si-Yang Maggie Liu, Hong-Hong Yan, Liyan Ji, Yu Chen, Yuhua Gong, Hong-Lian Lu, Jun-Tao Lin, Kai Yin, Ben-Yuan Jiang, Qiang Nie, Ri-Qiang Liao, Song Dong, Yanfang Guan, Pingping Dai, Xu-Chao Zhang, Jin-Ji Yang, Hai-Yan Tu, Xuefeng Xia, Xin Yi, Qing Zhou, Wen-Zhao Zhong, Xue-Ning Yang, Yi-Long Wu
Supplementary Data from Longitudinal Undetectable Molecular Residual Disease Defines Potentially Cured Population in Localized Non–Small Cell Lung Cancer

Funding

Guangdong Science and Technology Department

Translational Medicine in Lung Cancer

Leading Medical Talents in Guangdong Province

Guangdong Provincial People's Hospital Young Talent Project

China Postdoctoral Science Foundation

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ARTICLE ABSTRACT

The efficacy and potential limitations of molecular residual disease (MRD) detection urgently need to be fully elucidated in a larger population of non–small cell lung cancer (NSCLC). We enrolled 261 patients with stages I to III NSCLC who underwent definitive surgery, and 913 peripheral blood samples were successfully detected by MRD assay. Within the population, only six patients (3.2%) with longitudinal undetectable MRD recurred, resulting in a negative predictive value of 96.8%. Longitudinal undetectable MRD may define the patients who were cured. The peak risk of developing detectable MRD was approximately 18 months after landmark detection. Correspondingly, the positive predictive value of longitudinal detectable MRD was 89.1%, with a median lead time of 3.4 months. However, brain-only recurrence was less commonly detected by MRD (n = 1/5, 20%). Further subgroup analyses revealed that patients with undetectable MRD might not benefit from adjuvant therapy. Together, these results expound the value of MRD in NSCLC. This study confirms the prognostic value of MRD detection in patients with NSCLC after definitive surgery, especially in those with longitudinal undetectable MRD, which might represent the potentially cured population regardless of stage and adjuvant therapy. Moreover, the risk of developing detectable MRD decreased stepwise after 18 months since landmark detection.This article is highlighted in the In This Issue feature, p. 1599

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