Integration of Circulating Tumor DNA and Metabolic Parameters on 18F‐Fludeoxyglucose Positron Emission Tomography for Outcome Prediction in Unresectable Locally Advanced Non‐Small Cell Lung Cancer
Abstract This prospective study explores the prognostic value of circulating tumor DNA (ctDNA) and positron emission tomography/computed tomograpy (PET/CT) in unresectable locally advanced non‐small cell lung cancer (LA‐NSCLC) treated with definitive chemoradiotherapy (CRT). The discovery set includ...
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Wiley
2025-04-01
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| Series: | Advanced Science |
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| Online Access: | https://doi.org/10.1002/advs.202413125 |
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| author | Leilei Wu Zhenshan Zhang Chenxue Jiang Li Li Xiaojiang Sun Menglin Bai Ming Liu Kangli Xiong Jinbiao Shang Jinming Yu Shuanghu Yuan Yang Yang Yaping Xu |
| author_facet | Leilei Wu Zhenshan Zhang Chenxue Jiang Li Li Xiaojiang Sun Menglin Bai Ming Liu Kangli Xiong Jinbiao Shang Jinming Yu Shuanghu Yuan Yang Yang Yaping Xu |
| author_sort | Leilei Wu |
| collection | DOAJ |
| description | Abstract This prospective study explores the prognostic value of circulating tumor DNA (ctDNA) and positron emission tomography/computed tomograpy (PET/CT) in unresectable locally advanced non‐small cell lung cancer (LA‐NSCLC) treated with definitive chemoradiotherapy (CRT). The discovery set includes 62 patients, with 62 baseline and 53 post‐CRT plasma samples. PET/CT is performed at baseline, and 33 patients undergo mid‐treatment scans after 40 Gy. Baseline ctDNA is detected in 71.0% of patients. Pre‐treatment ctDNA concentration correlates with total metabolic tumor volume (TMTV) (p < 0.001) and total lesion glycolysis (TLG) (p = 0.001) but not treatment response or survival. However, patients with undetectable ctDNA and low TMTV show significantly longer progression‐free survival (PFS) (34.2 vs 10.1 months, p = 0.027). Post‐CRT, ctDNA is detected in 47.2% of patients, while ctDNA concentration (p = 0.005) and variant allele frequency (VAF) (p = 0.005) significantly decline. Undetectable post‐CRT ctDNA associates with longer PFS (p < 0.001) and overall survival (OS) (p = 0.001). Higher ∆TMTV correlates with improved PFS and OS. Similar findings were obtained in a test of 19 patients. These results highlight post‐CRT ctDNA and ∆TMTV as robust prognostic markers, potentially identifying patients who may forgo ICI consolidation. |
| format | Article |
| id | doaj-art-add2fddcec25466e976918bac96f19bc |
| institution | DOAJ |
| issn | 2198-3844 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | Advanced Science |
| spelling | doaj-art-add2fddcec25466e976918bac96f19bc2025-08-20T03:04:17ZengWileyAdvanced Science2198-38442025-04-011213n/an/a10.1002/advs.202413125Integration of Circulating Tumor DNA and Metabolic Parameters on 18F‐Fludeoxyglucose Positron Emission Tomography for Outcome Prediction in Unresectable Locally Advanced Non‐Small Cell Lung CancerLeilei Wu0Zhenshan Zhang1Chenxue Jiang2Li Li3Xiaojiang Sun4Menglin Bai5Ming Liu6Kangli Xiong7Jinbiao Shang8Jinming Yu9Shuanghu Yuan10Yang Yang11Yaping Xu12Department of Radiation Oncology Shanghai Pulmonary Hospital School of Medicine Tongji University Shanghai 200433 ChinaDepartment of Thoracic Surgery Shanghai Pulmonary Hospital School of Medicine Tongji University Shanghai 200433 ChinaDepartment of Radiation Oncology Shanghai Pulmonary Hospital School of Medicine Tongji University Shanghai 200433 ChinaDepartment of Radiation Oncology The First Affiliated Hospital of USTC Division of Life Sciences and Medicine University of Science and Technology of China Hefei Anhui 230001 ChinaDepartment of Radiation Oncology Zhejiang Cancer Hospital Hangzhou 310022 ChinaDepartment of Radiation Oncology Qilu Hospital of Shandong University Jinan Shandong 250012 ChinaDepartment of Radiation Oncology Shanghai Pulmonary Hospital School of Medicine Tongji University Shanghai 200433 ChinaGeneseeq Research Institute Nanjing Geneseeq Technology Inc Nanjing 210008 ChinaDepartment of Thyroid Surgery Zhejiang Cancer Hospital Hangzhou 310022 ChinaDepartment of Radiation Oncology Shandong Cancer Hospital and Institute Shandong First Medical University and Shandong Academy of Medical Sciences Jinan Shandong 250117 ChinaDepartment of Radiation Oncology The First Affiliated Hospital of USTC Division of Life Sciences and Medicine University of Science and Technology of China Hefei Anhui 230001 ChinaDepartment of Thoracic Surgery Shanghai Pulmonary Hospital School of Medicine Tongji University Shanghai 200433 ChinaDepartment of Radiation Oncology Shanghai Pulmonary Hospital School of Medicine Tongji University Shanghai 200433 ChinaAbstract This prospective study explores the prognostic value of circulating tumor DNA (ctDNA) and positron emission tomography/computed tomograpy (PET/CT) in unresectable locally advanced non‐small cell lung cancer (LA‐NSCLC) treated with definitive chemoradiotherapy (CRT). The discovery set includes 62 patients, with 62 baseline and 53 post‐CRT plasma samples. PET/CT is performed at baseline, and 33 patients undergo mid‐treatment scans after 40 Gy. Baseline ctDNA is detected in 71.0% of patients. Pre‐treatment ctDNA concentration correlates with total metabolic tumor volume (TMTV) (p < 0.001) and total lesion glycolysis (TLG) (p = 0.001) but not treatment response or survival. However, patients with undetectable ctDNA and low TMTV show significantly longer progression‐free survival (PFS) (34.2 vs 10.1 months, p = 0.027). Post‐CRT, ctDNA is detected in 47.2% of patients, while ctDNA concentration (p = 0.005) and variant allele frequency (VAF) (p = 0.005) significantly decline. Undetectable post‐CRT ctDNA associates with longer PFS (p < 0.001) and overall survival (OS) (p = 0.001). Higher ∆TMTV correlates with improved PFS and OS. Similar findings were obtained in a test of 19 patients. These results highlight post‐CRT ctDNA and ∆TMTV as robust prognostic markers, potentially identifying patients who may forgo ICI consolidation.https://doi.org/10.1002/advs.202413125ctDNAdefinitive chemoradiotherapyimmune checkpoint inhibitorsLA‐NSCLCPET metabolic parameters |
| spellingShingle | Leilei Wu Zhenshan Zhang Chenxue Jiang Li Li Xiaojiang Sun Menglin Bai Ming Liu Kangli Xiong Jinbiao Shang Jinming Yu Shuanghu Yuan Yang Yang Yaping Xu Integration of Circulating Tumor DNA and Metabolic Parameters on 18F‐Fludeoxyglucose Positron Emission Tomography for Outcome Prediction in Unresectable Locally Advanced Non‐Small Cell Lung Cancer Advanced Science ctDNA definitive chemoradiotherapy immune checkpoint inhibitors LA‐NSCLC PET metabolic parameters |
| title | Integration of Circulating Tumor DNA and Metabolic Parameters on 18F‐Fludeoxyglucose Positron Emission Tomography for Outcome Prediction in Unresectable Locally Advanced Non‐Small Cell Lung Cancer |
| title_full | Integration of Circulating Tumor DNA and Metabolic Parameters on 18F‐Fludeoxyglucose Positron Emission Tomography for Outcome Prediction in Unresectable Locally Advanced Non‐Small Cell Lung Cancer |
| title_fullStr | Integration of Circulating Tumor DNA and Metabolic Parameters on 18F‐Fludeoxyglucose Positron Emission Tomography for Outcome Prediction in Unresectable Locally Advanced Non‐Small Cell Lung Cancer |
| title_full_unstemmed | Integration of Circulating Tumor DNA and Metabolic Parameters on 18F‐Fludeoxyglucose Positron Emission Tomography for Outcome Prediction in Unresectable Locally Advanced Non‐Small Cell Lung Cancer |
| title_short | Integration of Circulating Tumor DNA and Metabolic Parameters on 18F‐Fludeoxyglucose Positron Emission Tomography for Outcome Prediction in Unresectable Locally Advanced Non‐Small Cell Lung Cancer |
| title_sort | integration of circulating tumor dna and metabolic parameters on 18f fludeoxyglucose positron emission tomography for outcome prediction in unresectable locally advanced non small cell lung cancer |
| topic | ctDNA definitive chemoradiotherapy immune checkpoint inhibitors LA‐NSCLC PET metabolic parameters |
| url | https://doi.org/10.1002/advs.202413125 |
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