Belinda Lee, MBBS, on Early-Stage Pancreatic Cancer: New Data on Guiding Adjuvant Chemotherapy
2024 ASCO Annual Meeting
Belinda Lee, MBBS, of Peter MacCallum Cancer Centre, Northern Health, Walter & Eliza Hall Institute, Melbourne, discusses findings from the AGITG DYNAMIC-Pancreas trial on the potential role of serial circulating tumor DNA testing after upfront surgery to guide adjuvant chemotherapy for early-stage disease (Abstract 107).
Transcript
Disclaimer: This video transcript has not been proofread or edited and may contain errors.
I'm here today to talk to you about the DYNAMIC-Pancreas clinical trial. This was a non-randomized phase 2 study looking at the potential role of circulating tumor DNA testing after upfront surgery to guide adjuvant chemotherapy for early-stage pancreatic cancer patients. In this study, we explored the feasibility and clinical utility of tumor-informed ctDNA testing for patients after surgery to see if we could guide their treatment. This study confirmed that the prognostic significance of ctDNA as a biomarker after surgery in early-stage pancreatic cancer. Even when ctDNA is not detected after surgery, there is still a high risk of recurrence that remains. We enrolled 102 patients from 26 Australian cancer centers exploring the feasibility and clinical utility of circulating tumor DNA. We looked to ask questions like, can the use of ctDNA inform us about the risk of recurrence in our patients, and can we use ctDNA to guide the use of adjuvant chemotherapy comparing three versus six months duration of chemotherapy, as well as comparing the use of different intensities of chemotherapy looking at triplet versus doublet chemotherapy in our patients?
What we found was that ctDNA does indeed provide prognostic significance in early-stage pancreatic cancer. However, even in the negative ctDNA cohort, the risk of relapse remains. We would still advise that you give six months of adjuvant chemotherapy treatment. While ctDNA-negative indicates as low risk of recurrence, patients should still undergo their adjuvant chemotherapy treatment, and future studies should incorporate the use of ctDNA after treatments from surgery, as well as after adjuvant chemotherapy. Changes in ctDNA may be used to track the changes in the patient's tumor burden throughout their treatment. We could also use ctDNA to integrate ctDNA into new studies looking at novel agents as well.
The ASCO Post Staff
Georgina V. Long, MD, PhD, of the Melanoma Institute Australia and The University of Sydney, discusses final results with up to 10 years’ follow-up data of the COMBI-AD study of patients with stage III BRAF-mutated melanoma who received adjuvant dabrafenib plus trametinib (Abstract 9500).
The ASCO Post Staff
Omid Hamid, MD, of The Angeles Clinic and Research Institute, a Cedars-Sinai affiliate, discusses updated data on IMC-F106C, a novel bispecific protein that, in a phase I safety and efficacy study, exhibited clinical activity in patients with unresectable or metastatic cutaneous melanoma who were pretreated with immune checkpoint inhibitors. A phase III trial of IMC-F106C with nivolumab in the first-line setting of metastatic disease has been initiated (NCT06112314; Abstract 9507).
The ASCO Post Staff
Milana Bergamino Sirvén, MD, PhD, of Spain’s Institute of Cancer Research, discusses her findings on molecular profiling of patients with estrogen receptor–positive, HER2-positive early-stage breast tumors after short-term preoperative endocrine therapy. This study suggests that such profiling may help clinicians identify those patients with a favorable prognosis for adjuvant endocrine therapy and those who may require additional treatment (Abstract 560).
The ASCO Post Staff
Yasmin H. Karimi, MD, of the University of Michigan Comprehensive Cancer Center, discusses 2.5-year follow-up data on epcoritamab monotherapy for patients with relapsed or refractory large B-cell lymphoma. The subcutaneous regimen continues to demonstrate durable responses (Abstract 7039).
The ASCO Post Staff
Sherene Loi, MD, PhD, of Peter MacCallum Cancer Centre, discusses a circulating tumor DNA (ctDNA) analysis from a cohort of patients with early-stage breast cancer who were enrolled in the monarchE trial. This large cohort was studied to look at the usefulness of a personalized tumor-informed assay for ctDNA detection in early stage high-risk patients (LBA507).