Abstract

Abstract Lung cancer is the leading cause of cancer-associated deaths in North America, with the vast majority being non-small cell lung cancer (NSCLC) with a five-year survival rate of only 24%. Non-invasive discovery of biomarkers associated with early-diagnosis of NSCLC can enable precision oncology efforts using liquid biopsy-based multiomic profiling of plasma cell-free DNA. Although tissue biopsies are currently the gold standard for tumor profiling, this method presents many limitations since these are invasive, risky, and sometimes hard to obtain as well as only giving a limited tumor profile. Blood-based, biomarker directed liquid biopsies provide a less-invasive, more robust approach to interrogate both tumor- and non-tumor-derived signals. Liquid biopsies can delineate complex tumoral genomic and proteomic profiles throughout tumor evolution and are increasingly used for cancer diagnostics that enables a precision oncology approach. We intend to examine 30 stage III-IV NSCLC pre-surgical patients and collect plasma samples. Cell-free DNA (cfDNA) will be extracted from plasma, and next-generation sequencing (NGS) performed as well as comparative traditional diagnostics. Through the analysis of tumor-specific alterations used as biomarkers, including single nucleotide variants (SNVs), insertions, deletions, copy number variations (CNVs), and methylation alterations we intend to identify tumor-derived DNA—ctDNA, among the total pool of cfDNA. Analysis of cancer genotyping for diagnostic purposes will also be compared to accuracy of traditional, imaging and tissue-based techniques. Using liquid biopsies offer opportunities to improve the surveillance of cancer patients during treatment and would supplement current diagnosis and tumor profiling strategies previously not readily available in Trinidad and Tobago. There are a vast number of advantages to use molecular biomarkers like liquid biopsies in diagnosis and tumor profiling as well as to monitor cancer patients, providing early information regarding disease evolution and treatment efficacy, and reorient treatment strategies rapidly, thereby improving clinical oncology outcomes. With the development of both experimental protocols and computational methods dedicated to liquid biopsy, the implementation of multi-omics strategies into the clinical workflow, especially in an under-performing clinical diagnostic system, will benefit the clinical management of cancers including decision-making guidance and patient outcome improvement in the underserved communities of Trinidad and Tobago. Citation Format: Samuel M. West, Nicole Ramlachan. Using novel multiomic plasma profiling from liquid biopsies to identify potential signatures for disease diagnostics in late-stage non-small cell lung cancer (NSCLC) in Trinidad and Tobago [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr C028.

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