Development and application of a precision cell-free DNA (cfDNA) minimal residual disease (MRD) test to enable optimized treatment selection in patients with genitourinary (GU) cancers.

• DOI: 10.1200/jco.2024.42.4_suppl.473
• Publication Date: 2024-01-29T21:06:41Z
• Authors: Derrian Cooley; Ulka N. Vaishampayan; Samuel Kaffenberger; Linda Drnek; Bryan Johnson; Laura Elaine Lamb; Nickolay A. Khazanov; Daniel H. Hovelson; Kat Kwiatkowski; Daniel R. Rhodes; Scott A. Tomlins; Khaled Hafez; Lindsey A. Herrel; Jeffrey S. Montgo...; Amy Gursky; Aaron M. Udager; Todd Matthew Morgan
• Keywords: Minimal Residual Disease; Cell-free fetal DNA

473 Background: By predicting those most likely to relapse, cfDNA-based MRD testing has potential clinical utility for adjuvant therapy decision making. Ideally, would be paired with validated treatment selection enable precision therapy. Herein we report the development and application of a combined personalized test patients GU cancer. Methods: Patients clinically localized solid tumors undergoing definitive were enrolled on prospective trial (NCT05082701) where was performed standard imaging-based disease recurrence monitoring. StrataMRD 2 tubes peripheral blood through assessment 1-12 tracer mutations identified via tumor tissue profiling by Strata Select, which also provides genomic profiling, angiogenesis inhibitor immunotherapy response scores (Angio TRS IRS, respectively). cancers valid results from at least one time point eligible this analysis. Tissue biomarkers compared vs. 792 advanced tested same platform. Results: A total 49 who underwent surgery had cfDNA based (*Table). The median age 64 years, 92% male, 49% stage I or II (vs. 51% III); initial 11 weeks after 3 tests have been per patient. Overall, 4/49 (8.2%) an MRD+ test, 8/49 (16.3%) any (4 converted MRD- MRD+). Patient level sensitivity specificity in evaluable cohort (with concurrent subsequent imaging) 100% (6 / 6 recurrences) (24 24 not recurred), respectively. In cohort, 34% 52% renal cell carcinoma (RCC) IRS- Angio TRS-High, respectively, 29% 50%, RCC similar testing. Similarly, 15%, 14% bladder other IRS-High, 27% 13% cancers, Conclusions: Personalized high routine imaging detecting cancers. Combined enables individualized Clinical information: NCT05082701 . [Table: see text]