作者
Yi Pan,Jiatao Zhang,Xuan Gao,Zhiyong Chen,Bingxue Yan,Peixin Tan,Xiaorong Yang,Wei Gao,Yuhua Gong,Zijian Tian,Si‐Yang Maggie Liu,Hui Lin,Hao Sun,Jie Huang,Siyang Liu,Hong‐Hong Yan,Song Dong,Chong‐Rui Xu,Hua-Jun Chen,Zhen Wang,Pansong Li,Yanfang Guan,Bin-Chao Wang,Jing Yang,Hai‐Yan Tu,Xue‐Ning Yang,Wen‐Zhao Zhong,Xuefeng Xia,Xin Yi,Qing Zhou,Yi‐Long Wu
摘要
The value of circulating tumor DNA (ctDNA) during chemoradiotherapy (CRT) remains unclear but is critical for detecting molecular residual disease (MRD). In this prospective study, we sequenced 761 blood samples from 139 patients with locally advanced non-small cell lung cancer treated with definitive radiation therapy (RT). ctDNA concentrations showed a significantly declining trend as CRT progressed at on-RT and after-RT time points versus baseline. Thirty-eight (27.3%) patients with early undetectable ctDNA at both on-RT (RT reached 40 Gy) and after-RT time points, indicating early response to CRT, had better survival outcomes for both with or without consolidation immune checkpoint inhibitors. Longitudinal undetectable MRD was found in 20.1% patients. The 2-year cancer-specific progression-free survival of these patients was 88.4%, corresponding to a potentially cured population. Further analysis revealed that pretreatment ctDNA variants serve as an essential MRD informed source. These data provide clinical insights for ctDNA-MRD detection.