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Scientific Calendar October 2023

Non-small cell lung cancer (NSCLC): accurate staging and ctDNA monitoring

How can the diagnosis, staging, monitoring and outcome of NSCLC patients be improved?

By ensuring accurate staging with a molecular diagnostic assay that offers a reliable basis for treatment decisions and ctDNA monitoring via an NGS-based kit – this provides an opportunity for earlier recurrence detection, thus improving patients’ clinical outcome.

By using CT imaging for diagnostic and surveillance purposes.

By using MRI for all diagnostic purposes during the whole patient pathway.

By taking biopsies for the initial histology-based diagnosis and conducting repeated biopsy procedures during follow-ups to evaluate a potential recurrence.

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Scientific background

Lung cancer is the leading cause of cancer-related deaths worldwide with more than 2 million new cases and 1.8 million deaths in 2020. [1] Moreover, due to the increase in global tobacco consumption, the World Health Organization estimates that lung cancer death rates will continue to rise.

The extent of nodal involvement is an important component in lung cancer staging and generally determines whether curative-intent surgery is feasible. It also informs subsequent treatment decisions. In NSCLC, surgery remains the best chance for a cure for early-stage patients. However, up to 30% of those patients experience recurrences after surgery. This is partly due to occult metastases in the lymph nodes that are missed by standard histology, which analyses only a small portion of the node. This is a major concern since nodal status determines patient survival and guides intra- and post-operative treatment decisions.

Modern personalized oncology requires molecular diagnostics, where specific tumor-related DNA mutations serve as key biomarkers for diagnosis, prognosis and monitoring of treatment response. These DNA alterations can be detected in the tumor tissue itself but also in plasma samples of cancer patients, in a technique known as liquid biopsy. This is especially important for lung cancer patients, where a traditional biopsy procedure is often challenging and, in some cases, not viable. Moreover, liquid biopsy offers repetitive and easier sampling opportunities with less patient discomfort and allows for better capturing of tumor heterogeneity. But not all liquid biopsies are equal; it is important to choose technology that is highly sensitive. Plasma-SeqSensei™ Solid Cancer IVD kit from Sysmex Inostics is an NGS-based liquid biopsy solution that offers highly sensitive detection of key DNA alterations down to 0.07% of mutant allele fraction.

References

[1] Sung H, et al. (2021): Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. PMID: 33538338

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