Thread by @BenWestphalen

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Background: Liquid biopsies have the potential to become an invaluable tool in the management of #cancer.
That’s why, it is important to generate solid evidence to define areas in which they can guide treatment decisions.

@OncoAlert 🚨 #LiquidBiopsies #PrecisionMedicine

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Accordingly, this paper by @LizzySmyth1 & team in @myESMO @Annals_Oncology on the prognostic value of longitudinal ctDNA 🧬💉 assessment in #EsophagealCancer #esocsm addresses a very relevant question.
@OncoAlert 🚨 #PrecisionMedicine #LiquidBiopsies
annalsofoncology.org/article/S0923-…

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✅ 97 patients that underwent neo-adjuvant chemotherapy & resection with a total of 245 available samples were identified in 🇬🇧 OCCAMS consortium dataset.

✅ Samples were analysed w a pan #cancer ctDNA panel

@OncoAlert 🚨

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Importantly (!), in contrast to other papers, the team decided to assess clonal hematopoiesis w indeterminate potential (CHIP) to tease out #cancer specific ctDNA. This is important, as this step is not necessarily standard (but should be).
@KlausMetzelerMD @OncoAlert 🚨

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Before filtering CHIP
🟢 16/79 (20%) pts has ctDNA post surgery
🟢 12/16 (75%) relapsed

After filtering CHIP
🟢 10/63 (17%) pts had ctDNA post surgery
🟢 9/10 (90%) relapsed

This underscores the importance of taking CHIP into account ✅

@KlausMetzelerMD @OncoAlert 🚨

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Importantly, these findings had prognostic implications:

Median #Cancer specific survival

w/o CHIP
⬇️ctDNA pos pats 14.9 months
⬆️ctDNA neg pats 29.5 months
HR 2.32

w CHIP
⬇️ctDNA pos pats 10 months
⬆️ctDNA neg pats 29.9 months
HR: 5.55

@Annals_Oncology @OncoAlert 🚨

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While the numbers are small, this paper shows that assessment of ctDNA holds great potential in various settings such as

✅ risk stratification
✅ disease monitoring
✅ allocation to clinical trials

& many many more…

Thanks to @LizzySmyth1 & team for their efforts!