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Rapid decrease of circulating tumor DNA predicted the treatment effect of nivolumab in a lung cancer patient within only 5 days

A 77-year-old Japanese man presented to our hospital with a 1-month history of low back pain and was diagnosed as having stage IV EGFR mutation-positive lung adenocarcinoma. After treatment with EGFR tyrosine kinase inhibitor and cytotoxic chemotherapy, nivolumab was started as fourth-line therapy....

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Autores principales: Iijima, Yuki, Hirotsu, Yosuke, Amemiya, Kenji, Higashi, Seishi, Miyashita, Yoshihiro, Omata, Masao
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5470530/
https://www.ncbi.nlm.nih.gov/pubmed/28649487
http://dx.doi.org/10.1016/j.rmcr.2017.05.015
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author Iijima, Yuki
Hirotsu, Yosuke
Amemiya, Kenji
Higashi, Seishi
Miyashita, Yoshihiro
Omata, Masao
author_facet Iijima, Yuki
Hirotsu, Yosuke
Amemiya, Kenji
Higashi, Seishi
Miyashita, Yoshihiro
Omata, Masao
author_sort Iijima, Yuki
collection PubMed
description A 77-year-old Japanese man presented to our hospital with a 1-month history of low back pain and was diagnosed as having stage IV EGFR mutation-positive lung adenocarcinoma. After treatment with EGFR tyrosine kinase inhibitor and cytotoxic chemotherapy, nivolumab was started as fourth-line therapy. Remarkable regression of the primary tumor was observed, suggesting high anti-tumor activity of nivolumab. We retrospectively investigated the change in circulating tumor DNA (ctDNA) variant allele fractions in serial plasma samples before and after the nivolumab therapy. Targeted sequencing analysis showed tumor-derived TP53(R249S) and EGFR(L858R) mutations detectable in plasma, and the timing of decrease was only 5 days, much earlier than the appearance of radiological changes. Overall, these results suggest that ctDNA might reflect tumor burden and might be a surrogate marker of the therapeutic efficacy of immune checkpoint therapy.
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spelling pubmed-54705302017-06-23 Rapid decrease of circulating tumor DNA predicted the treatment effect of nivolumab in a lung cancer patient within only 5 days Iijima, Yuki Hirotsu, Yosuke Amemiya, Kenji Higashi, Seishi Miyashita, Yoshihiro Omata, Masao Respir Med Case Rep Case Report A 77-year-old Japanese man presented to our hospital with a 1-month history of low back pain and was diagnosed as having stage IV EGFR mutation-positive lung adenocarcinoma. After treatment with EGFR tyrosine kinase inhibitor and cytotoxic chemotherapy, nivolumab was started as fourth-line therapy. Remarkable regression of the primary tumor was observed, suggesting high anti-tumor activity of nivolumab. We retrospectively investigated the change in circulating tumor DNA (ctDNA) variant allele fractions in serial plasma samples before and after the nivolumab therapy. Targeted sequencing analysis showed tumor-derived TP53(R249S) and EGFR(L858R) mutations detectable in plasma, and the timing of decrease was only 5 days, much earlier than the appearance of radiological changes. Overall, these results suggest that ctDNA might reflect tumor burden and might be a surrogate marker of the therapeutic efficacy of immune checkpoint therapy. Elsevier 2017-06-05 /pmc/articles/PMC5470530/ /pubmed/28649487 http://dx.doi.org/10.1016/j.rmcr.2017.05.015 Text en © 2017 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Iijima, Yuki
Hirotsu, Yosuke
Amemiya, Kenji
Higashi, Seishi
Miyashita, Yoshihiro
Omata, Masao
Rapid decrease of circulating tumor DNA predicted the treatment effect of nivolumab in a lung cancer patient within only 5 days
title Rapid decrease of circulating tumor DNA predicted the treatment effect of nivolumab in a lung cancer patient within only 5 days
title_full Rapid decrease of circulating tumor DNA predicted the treatment effect of nivolumab in a lung cancer patient within only 5 days
title_fullStr Rapid decrease of circulating tumor DNA predicted the treatment effect of nivolumab in a lung cancer patient within only 5 days
title_full_unstemmed Rapid decrease of circulating tumor DNA predicted the treatment effect of nivolumab in a lung cancer patient within only 5 days
title_short Rapid decrease of circulating tumor DNA predicted the treatment effect of nivolumab in a lung cancer patient within only 5 days
title_sort rapid decrease of circulating tumor dna predicted the treatment effect of nivolumab in a lung cancer patient within only 5 days
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5470530/
https://www.ncbi.nlm.nih.gov/pubmed/28649487
http://dx.doi.org/10.1016/j.rmcr.2017.05.015
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