Trial reportClinical cancer research : an official journal of the American Association for Cancer Research2022
Circulating Cell-free DNA as a Prognostic Biomarker in Patients with Advanced ALK+ Non-small Cell Lung Cancer in the Global Phase III ALEX Trial.
Trial report in Clinical cancer research : an official journal of the American Association for Cancer Research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
26 citing papers in PubMed, 1 synthesis or guideline pooled it, 44 citations in OpenAlex.
- The prognostic role of circulating DNA markers in patients with lung malignancies: a systematic review and meta-analysis.Biomarkers in medicine · 2025Pooled it
- Early experience with cerebrospinal fluid cell-free DNA molecular profiling in a neuro-oncology practice.Journal of neuro-oncology · 2026Article
- Modelled impact of a multi-cancer early detection screening programme on cancer treatment in England.British journal of cancer · 2026Article
- Diagnostic and Prognostic Value of cfDNA Concentration and Fragmentation in Prostate Cancer.The Prostate · 2026Article
- Circulating Cell-Free DNA Concentration as a Biomarker in Head and Neck Cancer.Oral diseases · 2025Article
- Refining Criteria for Choosing the First-Line Treatment for Real-World Patients with AdvancedInternational journal of molecular sciences · 2025Review
- Cell-Free DNA: Features and Attributes Shaping the Next Frontier in Liquid Biopsy.Molecular diagnosis & therapy · 2025Review
- Longitudinal Tracking ofJTO clinical and research reports · 2025Article
- EML4-ALK: Update on ALK Inhibitors.International journal of molecular sciences · 2025Review
- The Role of ctDNA in the Management of Non-Small-Cell Lung Cancer in the AI and NGS Era.International journal of molecular sciences · 2024Review
- Individualized Cell-Free DNA Monitoring With Chromosomal Junctions for Mesothelioma.JTO clinical and research reports · 2024Article
- Evaluating circulating cell-free DNA and DNA integrity index as biomarkers in non-small cell lung cancer.Journal of the Egyptian National Cancer Institute · 2024Article
- Putting comprehensive genomic profiling of ctDNA to work: 10 proposed use cases.The journal of liquid biopsy · 2024Review
- Unraveling the Potential of ALK-Targeted Therapies in Non-Small Cell Lung Cancer: Comprehensive Insights and Future Directions.Biomedicines · 2024Review
- Overcoming Central β-Sheet #6 (Cβ6)Lung Cancer (Auckland, N.Z.) · 2024Article
- Analysis of circulating tumor DNA identifies distinct therapeutic response to intraperitoneal and intravenous paclitaxel plus S-1 in gastric cancer patients with peritoneal metastasis.Therapeutic advances in medical oncology · 2024Article
- Article
- Review
- Clinical application of liquid biopsy based on circulating tumor DNA in non-small cell lung cancer.Frontiers in physiology · 2023Review
- Efficacy and safety of alectinib inTranslational lung cancer research · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors at 8 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeWe retrospectively assessed prognostic value of circulating cell-free DNA (cfDNA) using data from the phase III ALEX study in treatment-naïve, advanced ALK+ non-small cell lung cancer (NSCLC). PATIENTS AND
methodsPatients were randomized to receive twice-daily alectinib 600 mg (n = 152) or crizotinib 250 mg (n = 151). cfDNA was quantified from baseline plasma samples, with patients stratified into ≤median and >median cfDNA biomarker-evaluable populations (BEP). Effect of cfDNA concentration on outcomes was analyzed using a Cox regression model with treatment group as covariate, and in multivariate analyses.
resultsMedian cfDNA concentration in the BEP was 11.53 ng/mL (n = 276). A positive correlation was found between cfDNA concentration and number of lesions, organ lesion sites, and tumor size (sum of longest diameter; all P < 0.0001). In both treatment arms, patients in the >median BEP were more likely to experience disease progression than the ≤median BEP [alectinib adjusted HR = 2.04; 95% confidence interval (CI), 1.07-3.89; P = 0.0305 and crizotinib adjusted HR = 1.83; 95% CI, 1.11-3.00, P = 0.0169]. Median progression-free survival was longer with alectinib than crizotinib in both ≤median and >median BEPs (P < 0.0001). Overall survival data remain immature; survival probability was lower in the >median versus ≤median BEP in both treatment arms (alectinib HR = 2.52; 95% CI, 1.08-5.88; P = 0.0333 and crizotinib HR = 2.63; 95% CI, 1.27-5.47; P = 0.0096).
conclusionsThese data suggest that plasma cfDNA concentration may have prognostic value in advanced ALK+ NSCLC. Prospectively designed studies are warranted to investigate this finding.
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