ctDNA Reveals Genomic Differences of mRCC During First-, Second-Line Therapy

In this video, Sumanta K. Pal, MD, of City of Hope in Duarte, California, discusses a study that looked at differences in genomic alterations in the circulating tumor DNA (ctDNA) of patients with metastatic renal cell carcinoma (mRCC) in the first- and second-line treatment setting.

The researchers assessed ctDNA in 224 mRCC patients and found that among those with detected genomic alterations on second-line (56 patients) and first-line (64 patients) therapy, there were differences in TP53 (49% vs 25%, respectively), PIK3CA (17% vs 8%), NF1 (20% vs 15%), and others. Compared with patients still on first-line therapy, differences were even more stark among second-line patients who had previously received anti-VEGF therapy: TP53 (64% vs 31%), PIK3CA (29% vs 8%), and NF1 (29% vs 4%), possibly pointing to mechanisms and pathways of resistance.

The study (abstract 434) was presented at the 2017 American Society of Clinical Oncology (ASCO) Genitourinary Cancers Symposium, held February 16–18 in Orlando, Florida.