Abstract 1591: Cell-free DNA quantification reflects survival in non-small cell lung cancer patients with low metabolic tumor burden

Abstract

Abstract We aimed to assess the role of tumor biological behavior/aggressiveness measured by cell-free DNA (cfDNA) quantification according to metabolic tumor burden measured by FDG-PET/CT scan to predict survival of advanced non-small cell lung cancer (NSCLC). Newly-diagnosed eighty-two NSCLC patients with baseline cfDNA quantification and positron emission tomography/computed tomography (PET/CT) scan were prospectively enrolled. The cfDNA level was quantified by Agilent High Sensitivity DNA kit. Metabolic tumor burden was measured by metabolic tumor volume (MTV) and total lesion glycolysis (TLG) from PET/CT scan. The optimal cut-off value for cfDNA quantification, MTV, and TLG were found using X-tile analysis. The high-cfDNA quantification is associated with poor overall survival (OS) (hazard ratio=2.71, 95% confidential interval=1.33-5.52; p=0.006) than that of low. After categorized by metabolic tumor burden, however, the patients with high-MTV showed poor prognosis regardless of cfDNA quantification (low-cfDNA quantification vs high-cfDNA quantification, median OS = 3.9 months vs 7.0 months; p value > 0.05). On the other hands, the patients with high-cfDNA quantification showed poor prognosis in patients with low-MTV (low-cfDNA quantification vs high-cfDNA quantification, median OS = 52.8 months vs 22.9 months; p values < 0.001). According to baseline TLG level, the role of cfDNA quantification to predict survival was similar to MTV. Although cfDNA quantification independent prognostic factors for OS, the significance was disappeared when adjusted by MTV or TLG. This finding provides novel insights that the cfDNA quantification reflect survival for selected patients with low metabolic tumor burden in NSCLC. Citation Format: Myung Han Hyun, Eun Sung Lee, Jae Seon Eo, Jae Sook Sung, Eun Joo Kang, Yoon Jee Choi, Kyong Hwa Park, Sang Won Shin, Sung Yong Lee, Yeul Hong Kim. Cell-free DNA quantification reflects survival in non-small cell lung cancer patients with low metabolic tumor burden [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 1591.