Digital Droplet Polymerase Chain Reaction Detects Molecular Residual Disease in Resected NSCLC

Results of a study that aimed to evaluate the feasibility of digital droplet polymerase chain reaction (ddPCR) to detect specific driver gene mutations (EGFR L858R/19del or KRAS-G12C/D) in circulating tumor (ct)DNA to monitor for molecular residual disease (MRD) in patients with resected NSCLC with the aforementioned mutations were presented at the ESMO Congress 2023.

The study included 300 patients with resected NSCLC whose median age was 62 years. Among them, 54% had the EGFR L858R mutation, 34% had the EGFR 19del mutation, 10% had the KRAS mutation, and the remaining 2% had multiple mutations.

Among different gene mutations, the positive rates for MRD were 15% for EGFR L858R, 19% for EGFR 19del, and 18% for KRAS. According to the researchers’ binary logistic analysis, patients who received adjuvant therapy had a higher likelihood of MRD negativity (odds ratio [OR], 0.50; 95% CI, 0.27-0.95; P<.05). Higher TNM stage was associated with a higher likelihood of MRD positivity (OR, 2.13; 95% CI, 1.51-2.99; P<.001).

The researchers concluded that their findings indicated ddPCR is a feasible option for detecting MRD in resected NSCLC with common driver genes. “Considering the elevated prevalence of EGFR mutations in the Asian population, our personalized tumor-informed approach targeting EGFR may offer a cost-effective solution. Nevertheless, additional data are necessary to substantiate its efficacy.”

Source: Zhong R, Liang H, Jiang Y, et al. Personalized tumor-informed circulating tumor DNA (ctDNA) analysis for molecular residual disease (MRD) detection in resected non-small cell lung cancer (NSCLC) with common driver genes. Abstract of a poster presented at the ESMO Congress 2023; October 20-24, 2023; Madrid, Spain.