ArticleChest2021
Usefulness of Circulating Tumor DNA in Identifying Somatic Mutations and Tracking Tumor Evolution in Patients With Non-small Cell Lung Cancer.
Article in Chest, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.
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Who cites it
24 citing papers in PubMed.
- Risk-adapted therapy guided by human papillomavirus (HPV) circulating tumor DNA in HPV-positive oropharyngeal cancer (ReACT 1.0): an exploratory phase II trial.Nature communications · 2026Trial
- Multimodal Artificial Intelligence in Lung Cancer: From Data Integration to Precision Oncology.Cancers · 2026Review
- Current trends and future directions of artificial intelligence in lung cancer diagnosis.Chinese journal of cancer research = Chung-kuo yen cheng yen chiu · 2026Article
- Precision medicine in cutaneous melanoma-A comprehensive review.Journal of the European Academy of Dermatology and Venereology : JEADV · 2026Review
- Multistep ctDNA Monitoring of Minimal Residual Disease in Colorectal Cancer Liver Metastases: From Tissue NGS to Highly Sensitive Digital PCR Platforms.Diagnostics (Basel, Switzerland) · 2026Article
- Comprehensive Liquid Biopsy Approaches for the Clinical Management of Lung Cancer Using Multiple Biological Matrices.International journal of molecular sciences · 2025Review
- A narrative review of imaging intratumor heterogeneity in non-small cell lung cancer: current advances.Translational lung cancer research · 2025Review
- Dissecting Tumor Heterogeneity by Liquid Biopsy-A Comparative Analysis of Post-Mortem Tissue and Pre-Mortem Liquid Biopsies in Solid Neoplasias.International journal of molecular sciences · 2025Article
- Utility of Circulating Tumor DNA Assay in Identifying Mutations and Guiding Matched Targeted Therapy in Lung Cancers.Clinical Medicine Insights. Oncology · 2024Article
- Plasma-Based Comprehensive Genomic Profiling DNA Assays for Non-Small Cell Lung Cancer: A Health Technology Assessment.Ontario health technology assessment series · 2024Article
- A comparative study on ctDNA and tumor DNA mutations in lung cancer and benign cases with a high number of CTCs and CTECs.Journal of translational medicine · 2023Article
- Selpercatinib and Pralsetinib Induced Chylous Ascites in RET-Rearranged Lung Adenocarcinoma: A Case Series.Clinical lung cancer · 2023Article
- Potential biomarkers for immunotherapy in non-small-cell lung cancer.Cancer metastasis reviews · 2023Review
- Clinical Network Systems Biology: Traversing the Cancer Multiverse.Journal of clinical medicine · 2023Review
- Assessment of Barriers and Challenges to Screening, Diagnosis, and Biomarker Testing in Early-Stage Lung Cancer.Cancers · 2023Review
- Integration of artificial intelligence in lung cancer: Rise of the machine.Cell reports. Medicine · 2023Review
- Clinical application of liquid biopsy based on circulating tumor DNA in non-small cell lung cancer.Frontiers in physiology · 2023Review
- Predicting survival of NSCLC patients treated with immune checkpoint inhibitors: Impact and timing of immune-related adverse events and prior tyrosine kinase inhibitor therapy.Frontiers in oncology · 2023Article
- Biomarker-Targeted Therapies in Non-Small Cell Lung Cancer: Current Status and Perspectives.Cells · 2022Review
- Disease monitoring of epidermal growth factor receptor (EGFR)-mutated non-small-cell lung cancer patients treated with tyrosine kinase inhibitors via EGFR status in circulating tumor DNA.Thoracic cancer · 2022Article
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
backgroundThe usefulness of circulating tumor DNA (ctDNA) in detecting mutations and monitoring treatment response has not been well studied beyond a few actionable biomarkers in non-small cell lung cancer (NSCLC). RESEARCH QUESTION: How does the usefulness of ctDNA analysis compare with that of solid tumor biopsy analysis in patients with NSCLC?
methodsWe retrospectively evaluated 370 adult patients with NSCLC treated at the City of Hope between November 2015 and August 2019 to assess the usefulness of ctDNA in mutation identification, survival, concordance with matched tissue samples in 32 genes, and tumor evolution.
resultsA total of 1,688 somatic mutations were detected in 473 ctDNA samples from 370 patients with NSCLC. Of the 473 samples, 177 showed at least one actionable mutation with currently available Food and Drug Administration-approved NSCLC therapies. MET and CDK6 amplifications co-occurred with BRAF amplifications (false discovery rate [FDR], < 0.01), and gene-level mutations were mutually exclusive in KRAS and EGFR (FDR, 0.0009). Low cumulative percent ctDNA levels were associated with longer progression-free survival (hazard ratio [HR], 0.56; 95% CI, 0.37-0.85; P = .006). Overall survival was shorter in patients harboring BRAF mutations (HR, 2.35; 95% CI, 1.24-4.6; P = .009), PIK3CA mutations (HR, 2.77; 95% CI, 1.56-4.9; P < .001) and KRAS mutations (HR, 2.32; 95% CI, 1.30-4.1; P = .004). Gene-level concordance was 93.8%, whereas the positive concordance rate was 41.6%. More mutations in targetable genes were found in ctDNA than in tissue biopsy samples. Treatment response and tumor evolution over time were detected in repeated ctDNA samples.
interpretationAlthough ctDNA analysis exhibited similar usefulness to tissue biopsy analysis, more mutations in targetable genes were missed in tissue biopsy analyses. Therefore, the evaluation of ctDNA in conjunction with tissue biopsy samples may help to detect additional targetable mutations to improve clinical outcomes in advanced NSCLC.
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