Key clinical point : Higher vs. lower plasma levels of cell-free DNA (cfDNA) were associated with a greater proportion of lesions and progression events and worse survival in patients with advanced anaplastic lymphoma kinase gene-positive (ALK+) non–small-cell lung cancer (NSCLC).
Major finding : There was a positive correlation between plasma cfDNA levels and the number of lesions (Spearman’s correlation 0.30; P < .0001). Patients who had greater than the median vs. less than or equal to the median plasma levels of the cfDNA biomarker had a higher risk for disease progression events (alectinib group: adjusted hazard ratio [aHR] 2.04 [ P = .0305]; crizotinib group: aHR 1.83 [ P = .0169]) and mortality (alectinib group: HR 2.52 [ P = .0333]; crizotinib group: HR 2.63 [ P = .0096]).
Study details : The data come from an exploratory retrospective analysis including treatment-naive patients from the phase 3 ALEX trial who were randomly assigned to receive twice-daily 600 mg alectinib (n = 152) or 250 mg crizotinib (n = 151).
Disclosures: The study was funded by F. Hoffmann-La Roche Ltd. The authors reported ties with one or more pharmaceutical companies.
Source: Dziadziuszko R et al. Circulating cell-free DNA as a prognostic biomarker in patients with advanced ALK+ non–small cell lung cancer in the global phase III ALEX trial. Clin Cancer Res. 2022 (Mar 1)1. Doi: 10.1158/1078-0432.CCR-21-2840