Showing posts with label ctDNA. Show all posts
Showing posts with label ctDNA. Show all posts

Friday, June 7, 2024

Gyn Cancer Poster Session - Ovarian Cancer posters #ASCO24

Monday was Gyn Cancer Poster day at #ASCO24.  

Here are a few posters along with their study conclusions that I found most interesting this year. 

Tumor-informed ctDNA as an objective marker for postoperative residual disease in epithelial ovarian cancer. #5544
"The present tumor-informed dPCR SV fingerprint ctDNA approach demonstrated feasibility with remarkably high detection rates pre- and postoperatively. Postoperative ctDNA levels differed substantially based on postoperative tumor residuals. These findings suggest that this personalized approach could be used to develop a dPCR SV detection assay and may have clinical utility for postoperative MRD evaluation in patients with primary advanced HGSOC."  
Through the years there has been a lot of talk regarding detecting circulating tumor DNA in the blood of patients. This study showed ctDNA could be used  as a marker in ovarian cancer .


Differences in physical and emotional distress amongst patients undergoing neoadjuvant chemotherapy versus surgery for advanced ovarian cancer: Patient-reported outcomes at diagnosis.   #5546
"Advanced OC patients have high psychosocial needs, with NACT patients reporting severe perceived symptoms on PRO measures. The PSS-10 may be a valuable screening tool for patients undergoing NACT to prioritize supportive care services."

Use of cell-free DNA from ascites to identify variants and tumour evolution in a cohort of patients with advanced ovarian cancer. #5547
This work "demonstrated the reliability of using cfDNA from ascites for molecular profiling, allowing a liquid biopsy of ovarian cancer when tumor tissue access may be restricted. This approach improves accessibility of tumour material, allowing capture of clinically actionable mutations prior to surgery or upon recurrence, following tumour evolution."
There is a difference between cfDNA and ctDNA- "The ctDNA is the fraction of cfDNA that originates from tumor cells, which comes from three sources: apoptosis, necrosis, and active secretion. While ctDNA can come from apoptosis with fragment lengths similar to healthy patients, ctDNA is more fragmented or shorter than cfDNA [20,32,33]. "  Source : NIH

Gemcitabine plus cisplatin in recurrent ovarian, fallopian tube, and primary peritoneal cancer. #5548
"Cisplatin in combination with gemcitabine demonstrates activity regardless of platinum sensitivity status in patients with recurrent ovarian cancer. However, longer platinum-free interval is associated with improved response to this therapy".

 Evaluation of a novel extracellular vesicle (EV) based ovarian cancer (OC) screening test in asymptomatic postmenopausal women. #5553
"The OC Test is capable of highly sensitive and specific detection of HGSC in asymptomatic postmenopausal women one year prior to Dx and can detect HGSC up to three years prior to Dx with superior sensitivity and specificity compared to CA125." 
Finding a screening test for ovarian cancer is important.  This is a different approach looking at extracellular vesicles. " Extracellular vesicles (EVs) are generated and released by cells as part of various physiological and pathological processes, including the progression of ovarian cancer. "Source Science Direct
 

The BEV1L study: Do real-world outcomes associated with the addition of bevacizumab to first-line chemotherapy in patients with ovarian cancer reinforce clinical trial findings? #5563
"This real world study provides support for findings from ICON7 and GOG-0218, suggesting that the benefit of adding bev to first line chemotherapy may be limited to patients with high-risk clinical factors ( Stage IV disease or stage III disease with visible residual disease or no evidence of surgery). "

 
Association of physical activity with self-reported quality of life after primary chemotherapy for ovarian cancer. #5574
"We observed positive associations between health tracker physical activity data and pt-reported QOL. Stronger associations were observed in younger pts. Interventions aimed at increasing physical activity may have broader quality of life benefits for individuals with ovarian cancer." 
When I was first diagnosed I was told to rest during chemotherapy treatment. When I recurred a few years later I was told to try to walk each day. I'm glad that theren is now data saying that exercise has QOL benefits.

 
Artificial intelligence to predict homologous recombination deficiency in ovarian cancer from whole-slide histopathological images. #5578
"By harnessing the power of deep neural networks (DNN), we provide a rapid and scalable solution for HRD prediction, circumventing the limitations of traditional molecular assays. Successful integration of this deep learning model into routine pathology workflows could significantly enhance diagnostic efficiency, reduce the turnaround time and financial cost compared with molecular assay. " 
There were a number of talks at ASCO related to the use of AI. HRD is a marker used to manage ovarian cancer patient treatments.

 
Germline genetic profiles of women with ovarian malignancies: A Myriad Collaborative Research Registry study #5585
"Based on this large registry, our data showed that over 15% of patients with ovarian malignancies have mutations in BRCA (12.5%) or Lynch genes (2.6%) with varying prevalence by race, age, and tumor site. Noted disparities indicate the importance of universal testing in patients with epithelial ovarian malignancies."  
I knew that Lynch syndrome was associated with endometrial cancer but I did not associate ovarian cancer with Lynch sydrome. 

 
Which posters caught your eye? Share them in a comment below.
Tomorrow,  I will post about a equity symposium I attended as well as the  connections and reconnections I made at the annual meeting.
Dee
Every Day is a Blessing!

Tuesday, March 19, 2024

2024 SGO Annual Meeting Sunday March 17th Session Review

 

I started the day off attending an ISS ( Industry Sponsored Symposium) which reviewed the use of ADC's ( antibody drug conjugates ) in gynecologic cancers. The session included patient case reviews where the audience and speakers were asked what treatment they would choose for a patient with a specific treatment experience and co-morbidities. It was very interesting to "listen in" on the discussion. 

The next session was a review by the editors of Gynecologic Oncology and Gyn Oncology Reports of their magazines in terms of readership, reviews and future expansion of clinical guidelines. 

The Presidential Invited Speaker was Erin Diehl who presented on  "F" Words at Work. With a bit of improv she talked about failure, #failfluence and the importance of reframing the failure to improve ourselves.


Focused Plenary IV on ctDNA was an interesting group of abstracts all dealing with using circulating DNA for prediction of disease.

 

This study included a new term for me - Fragmentomics -  the investigation of fragmentation patterns of cell-free DNA (cfDNA). 

This was an interesting proof of concept study

 I also attended the Late Breaking Abstract Session.  

This was an interesting study of using Avutometinib plus defactinib ( Kinase inhibitors)  for Low Grade Serous Ovarian Cancer.

This study did not reach the endpoint expected so the study was ended. We may want all the studies to be successful but we can always learn from studies that are not working. 

Focusing on ARID1A in ovarian clear cell and endometriod endometrial cancers. 

This study compared different diagnostic tests for ovarian cancer in post-menopausal women. 

 

I was pleased to see the rarer ovarian cancers being discussed.

Thanks to Dr.Monica Avila (@MAvilaMD) and CrozrX (@CrozrX) for sharing their insights into the studies presented. 

 

Next post will be what I learned on Monday the last day of the meeting.

Dee

Every Day is a Blessing!

 

Friday, June 9, 2023

ASCO23 Day 4 (6/5/23) Gyn Cancer Posters, Poster Discussion session & Misc topics

Note: Due to the number of Tweets embedded in this post the page may take some time to load.  

Monday's sessions included the Gyn Cancer Poster session and the Poster Discussion session. There were a few other sessions that I found interesting and are included at the end of this post. 

Poster Discussion Session

Initial efficacy and safety results from ENGOT-ov60/GOG-3052/RAMP 201: A phase 2 study of avutometinib (VS-6766) ± defactinib in recurrent low-grade serous ovarian cancer (LGSOC). ABSTRACT 5515
 
Randomized phase 2 study of gemcitabine with or without ATR inhibitor berzosertib in platinum-resistant ovarian cancer: Final overall survival (OS) and biomarker analyses. ABSTRACT 5512
"Gemcitabine/berzosertib did not significantly improve OS versus gemcitabine alone. Pts with PFI≤3 months and pts with RS-low tumors may derive a survival advantage from addition of berzosertib to gemcitabine in the platinum-resistant setting. Clinical trial information: NCT02595892."
 
Correlation of cyclin E1 expression and clinical outcomes in a phase 1b dose-escalation study of azenosertib (ZN-c3), a WEE1 inhibitor, in combination with chemotherapy (CT) in patients (pts) with platinum-resistant or refractory (R/R) epithelial ovarian, peritoneal, or fallopian tube cancer (EOC). ABSTRACT 5513
"Study assessed azenosertib + paclitaxel (PAC), carboplatin (Carbo), gemcitabine (GEM), or pegylated liposomal doxorubicin (PLD) in pts with metastatic high-grade serous EOC after ≤2 lines of chemotherapy. Patients with Cyclin E1 overexperessing tumors, a subgroup with suboptimal benefits from chemo , demonstrated significant imporovements in ORR and PFS vs patients with tumors having low expresssion."

 
A phase II trial of palbociclib combined to letrozole after progression on second-line chemotherapy for women with ER/PR-positive high-grade serous or endometrioid ovarian, fallopian tube, or peritoneal cancer: LACOG 1018.  ABSTRACT 5541
"Palbociclib combined to letrozole demonstrated a significant efficacy in terms of PFS rate at 12 weeks (63.4%) and CBR (71.8%), with no new safety concerns in women with recurrent advanced and metastatic hormone receptor-positive ovarian cancer. These results warrant further investigation of palbociclib plus letrozole in high-grade ovarian cancer."
The Normal Risk Ovarian Screening Study (NROSS): Twenty-one year update. ABSTRACT 5522
"A total of 7,856 healthy postmenopausal women were screened annually for a total of 50,596 women-years in a single arm study (NCT00539162). Serum CA125 was analyzed with the Risk of Ovarian Cancer Algorithm (ROCA) each year....An elevated ROCA, characterized by a significantly rising CA125, prompted referral of 2% of participants to transvaginal sonography (TVS) each year and required only 2 operations to detect each case of ovarian cancer, indicating that CA125 used in this way is adequately specific for effective screening.
Posters
Here are a few posters I found interesting that were not part of the discussion session. 

Efficacy and safety of niraparib maintenance therapy in patients with newly diagnosed advanced ovarian cancer who had measurable residual disease: A post-hoc subgroup analysis of the PRIME study. ABSTRACT 5562

"This study aims to report the efficacy, including antitumor activity, and safety of niraparib maintenance therapy in patients with measurable residual disease MRD after first-line platinum-based chemotherapy1LCT from the phase 3 PRIME trial. ...  Median PFS (95% CI) was 22.3 (8.7–not estimable) months with niraparib versus 8.3 (5.6–11.0) months with placebo (hazard ratio, 0.36; 95% CI, 0.19–0.71)."


Circulating tumor DNA (ctDNA) as a marker of residual disease and recurrence in resected stage I-IV epithelial ovarian cancer (EOC). ABSTRACT 5553
ctDNA detection after ovarian cancer cytoreduction identifies pts at very high risk of recurrence. Pts with BRCA mutations were more likely to have negative ctDNA post-op. The role of ctDNA in guiding neoadjuvant and adjuvant therapy to improve outcomes, warrants further investigation. Clinical trial information: ACTRN12617001119381.
 

Safety and efficacy of PIPAC in ovarian cancer patients with peritoneal metastases: A first-in-US phase I study.  ABSTRACT 5554

"Pressurized intraperitoneal aerosolized chemotherapy (PIPAC) is a novel IP drug delivery method that optimizes tissue penetration depth and drug distribution, to treat recurrent peritoneal malignancies. 

PIPAC with cisplatin/doxorubicin in platinum-resistant ovarian cancer is well tolerated. Intraperitoneal responses were seen in a subset of low-grade serous ovarian cancer patients, which may warrant further study."



 

Miscellaneous ASCO topics: 

Patient Centered Research

Solid tumor research

Destiny Pan-Tumor-02
Her-2 expressing tumors -trastuzumab deruxtecan (T-DXd)

 

This brings my highlights from the ASCO 2023 Annual meeting to a close. I hope to see everyone in person next year!

 Dee

Every Day is a Blessing ! 

Monday, June 13, 2016

The Days of ASCO- Liquid Biopsies

While planning which sessions I would attend I ran across a joint AACR and ASCO session : The Next Frontier of Genomics and Clinical Trials.

One speaker was talking about big data and clinical trials. Accumulating large numbers of patient data - disease information / genetics/  treatment and response in one place will allow researchers to recognize patterns and best practices and that is a good thing.

But the session I couldn't wait to hear was Potential of Liquid Biopsies in Precision Medicine presentation by Dr Luis Diaz. I had often wondered if there was enough circulating tumor DNA (ctDNA) in the blood to measure accurately. And I wondered if you could find ctDNA from ovarian cancer tumors and maybe be able to detect ovarian cancer or a recurrence quicker.

What is a liquid biopsy? When a cancer cell dies it can shed DNA into the blood. This cell-free or circulating tumor DNA can be removed from the plasma and the genetic makeup can be studied. These DNA mutated fragments can be compared to normal alleles.

Why do a liquid biopsy? It is less invasive than a tissue biopsy. It may cost less. It may be used to follow response to treatment or signal a recurrence quicker and it can track genetic changes in the cancer. 

So on Saturday afternoon, I sat in a large standing room only session to listen to Dr Diaz. During his talk Dr Diaz mentioned a pancreatic cancer study where  ctDNA spiked along with the tumor marker CA19-9 showing that liquid biopsy could be used to track a recurrence. Another study (not sure of which cancer ) showed that a rising ctDNA signaled a recurrence which was confirmed by a CT scan.  I was tweeting from the meeting and wanted to be sure I heard correctly when Dr Diaz mentioned that liquid biopsy could only be used for somatic mutations, so I tweeted.
And got these responses 




There were also other presentations/ posters on the use of liquid biopsy.

During a Tumor Biology presentation, Dr. P. Mack shared results of a study of blood samples from over 5,000 patients with 50 different tumor types (39% lung, 14% breast , 10% colon cancers) . Some of the samples were compared to patient tumor samples. The ctDNA test found mutations in 83% of the samples. And overall 87% of the ctDNA results matched the tumor samples. You may read more about this study here.

Another abstract by Dr Tie showed that the detection of ctDNA in patients with stage II colon cancer who had undergone surgery provided direct evidence of residual disease.

Circulating cell-free DNA : The future of personalized medicine in ovarian cancer management was presented as a poster. The poster reported on a study of ctDNA in the blood of 14 women with ovarian cancer. The tumor tissue of the women underwent next-generation sequencing. The researchers found that ctDNA detected more mutations than what was found in the solid tumors. (poster abstract.).


A number of companies (including Guardant Health which was used in the Mack study) have introduced liquid biopsy equipment.

I look forward to the application of ct DNA in future ovarian cancer research/ treatment.

Dee
Every Day is a Blessing!

Monday, March 21, 2016

SGO News via Twitter - March 19-20

Since I was unable to go to San Diego for this year's annual  SGO ( Society of Gynecologic Oncologists) meeting, I've been following the meeting's hashtag #sgomtg on Twitter instead.
Here are the tweets I favorited for the March 19-20th. 
ctDNA - Circulating DNA(https://www.genome.gov/27556716)







SNP = single-nucleotide polymorphism ("most common sequence variation in the human genome is the stable substitution of a single base" (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2410167/)

I appreciate the ability to have interactions with the gyn oncs and other advocates attending the meeting.

Check back on Wednesday for the tweets I found most interesting for the last two days of the meeting.

Dee
Every Day is a Blessing!