Liquid Biopsy Predicts Immunotherapy Response and Toxicity in Advanced Lung Cancer Patients

Immunotherapy has been a game-changer in treating lung cancer patients, yet assessing its effectiveness remains a challenge. The absence of reliable biomarkers means reliance on imaging and patient symptoms to gauge clinical responses. Now, new noninvasive tests offer clinicians a way to evaluate treatment responses and foresee potential side effects at an early stage, allowing for timely adjustments in therapeutic approaches.

Researchers at Johns Hopkins Medicine (Baltimore, MD, USA) have explored the use of a "liquid biopsy" to analyze genetic material from tumors that enter the bloodstream along with immune cells. This approach could enable clinicians to predict which patients with advanced lung cancers are responding to immunotherapies and identify those who might experience immune-related side effects later on. In a study of 30 patients undergoing immunotherapy for metastatic non-small cell lung cancers, the team monitored changes in circulating tumor DNA (ctDNA). They found that molecular responses, indicated by the reduction of tumor genetic material in the bloodstream, were closely linked with progression-free and overall survival rates.

Additionally, the research included serial blood tests that identified an increase in T cells, the immune cells known for recognizing and attacking foreign entities on tumor cells. This was particularly evident in patients who developed immune-related adverse events, like lung tissue inflammation, up to five months before clinical symptoms appeared. This finding was corroborated in a separate group of 49 patients with advanced lung cancers. The liquid biopsy proved beneficial in understanding the clinical outcomes of patients who appeared to have stable disease on imaging.

“All of the patients who appeared to have stable disease on imaging tests had very different DNA molecular response patterns that helped predict their overall clinical outcomes,” said senior study author Valsamo “Elsa” Anagnostou, M.D., Ph.D. “This is a particular subset of patients for whom we may want to intervene, and use liquid biopsies to guide therapeutic decision-making, as ctDNA can rapidly and accurately capture the amount of cancer present.”

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