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- Title
Evaluation of Blood Tumor Mutation Burden for the Efficacy of Second-Line Atezolizumab Treatment in Non-Small Cell Lung Cancer: BUDDY Trial.
- Authors
Park, Cheol-Kyu; Jun, Ha Ra; Oh, Hyung-Joo; Lee, Ji-Young; Cho, Hyun-Ju; Kim, Young-Chul; Lee, Jeong Eun; Yoon, Seong Hoon; Choi, Chang Min; Lee, Jae Cheol; Lee, Sung Yong; Lee, Shin Yup; Chun, Sung-Min; Oh, In-Jae
- Abstract
This study aimed to investigate the feasibility of blood-based biomarkers, including blood tumor mutation burden (bTMB), to predict atezolizumab efficacy in relapsed and advanced non-small cell lung cancer (NSCLC). Stage IV NSCLC patients who had previously received platinum-doublet chemotherapy were recruited and received 1200 mg of atezolizumab every three weeks. Blood was collected to obtain plasma cell-free DNA (cfDNA) before the first cycle (C0) and at the fourth cycle (C4). bTMB was measured by CT-ULTRA in patients with cfDNA over 10 ng. The objective response rate (ORR) of the enrolled 100 patients was 10%, and there was no difference in ORR according to bTMB (cutoff: 11.5 muts/Mb) at C0 (high bTMB: 8.1% vs. low bTMB: 11.1%). However, the C4/C0 bTMB ratio was significantly lower in the durable clinical benefit (DCB) patients. The cfDNA concentration at C0, the C4/C0 ratio of the cfDNA concentration, the highest variant allele frequency (hVAF), and the VAF standard deviation (VAFSD) were significantly lower in the DCB patients. In the multivariate analysis, a high cfDNA concentration at C0 (cutoff: 8.6 ng/mL) and a C4/C0 bTMB ratio greater than 1 were significantly associated with progression-free survival. These results suggest that baseline levels and dynamic changes of blood-based biomarkers (bTMB, cfDNA concentration, and VAFSD) could predict atezolizumab efficacy in previously treated NSCLC patients.
- Subjects
NON-small-cell lung carcinoma; HEMATOMA; ATEZOLIZUMAB; CELL-free DNA
- Publication
Cells (2073-4409), 2023, Vol 12, Issue 9, p1246
- ISSN
2073-4409
- Publication type
Article
- DOI
10.3390/cells12091246