title: Use of Liquid Biopsies in Clinical Oncology: Pilot Experience in 168 Patients.
abstract: OBJECTIVE
  There is a growing interest in using circulating tumor DNA (ctDNA) testing in patients with cancer.
  
  
  METHODS
  A total of 168 patients with diverse cancers were analyzed. Patients had digital next-generation sequencing (54 cancer-related gene panel including amplifications in ERBB2, EGFR, and MET) performed on their plasma. Type of genomic alterations, potential actionability, concordance with tissue testing, and patient outcome were examined.
  
  
  RESULTS
  Fifty-eight percent of patients (98/168) had ≥1 ctDNA alteration(s). Of the 98 patients with alterations, 71.4% had ≥ 1 alteration potentially actionable by an FDA-approved drug. The median time interval between the tissue biopsy and the blood draw was 2.7 months for patients with ≥ 1 alteration in common compared with 14.4 months (P = 0.006) for the patients in whom no common alterations were identified in the tissue and plasma. Overall concordance rates for tissue and ctDNA were 70.3% for TP53 and EGFR, 88.1% for PIK3CA, and 93.1% for ERBB2 alterations. There was a significant correlation between the cases with ≥ 1 alteration with ctDNA ≥ 5% and shorter survival (median = 4.03 months vs. not reached at median follow-up of 6.1 months; P < 0.001). Finally, 5 of the 12 evaluable patients (42%) matched to a treatment targeting an alteration(s) detected in their ctDNA test achieved stable disease ≥ 6 months/partial remission compared with 2 of 28 patients (7.1%) for the unmatched patients, P = 0.02.
  
  
  CONCLUSIONS
  Our initial study demonstrates that ctDNA tests provide information complementary to that in tissue biopsies and may be useful in determining prognosis and treatment. Clin Cancer Res; 22(22); 5497-505. ©2016 AACR.
authors.affiliation: Center for Personalized Cancer Therapy and Division of Hematology and Oncology, UCSD Moores Cancer Center, La Jolla, California. mschwaederle@ucsd.edu.
authors.forename: Maria
authors.initials: M
authors.lastname: Schwaederle
authors.affiliation: Center for Personalized Cancer Therapy and Division of Hematology and Oncology, UCSD Moores Cancer Center, La Jolla, California.
authors.forename: Hatim
authors.initials: H
authors.lastname: Husain
authors.affiliation: Center for Personalized Cancer Therapy and Division of Hematology and Oncology, UCSD Moores Cancer Center, La Jolla, California.
authors.forename: Paul T
authors.initials: PT
authors.lastname: Fanta
authors.affiliation: Center for Personalized Cancer Therapy and Division of Hematology and Oncology, UCSD Moores Cancer Center, La Jolla, California.
authors.forename: David E
authors.initials: DE
authors.lastname: Piccioni
authors.affiliation: Center for Personalized Cancer Therapy and Division of Hematology and Oncology, UCSD Moores Cancer Center, La Jolla, California.
authors.forename: Santosh
authors.initials: S
authors.lastname: Kesari
authors.affiliation: Center for Personalized Cancer Therapy and Division of Hematology and Oncology, UCSD Moores Cancer Center, La Jolla, California.
authors.forename: Richard B
authors.initials: RB
authors.lastname: Schwab
authors.affiliation: Center for Personalized Cancer Therapy and Division of Hematology and Oncology, UCSD Moores Cancer Center, La Jolla, California.
authors.forename: Sandip P
authors.initials: SP
authors.lastname: Patel
authors.affiliation: Division of Biomedical Informatics, Department of Medicine, UC San Diego School of Medicine, La Jolla, California.
authors.forename: Olivier
authors.initials: O
authors.lastname: Harismendy
authors.affiliation: Center for Personalized Cancer Therapy and Division of Hematology and Oncology, UCSD Moores Cancer Center, La Jolla, California.
authors.forename: Megumi
authors.initials: M
authors.lastname: Ikeda
authors.affiliation: Center for Personalized Cancer Therapy and Division of Hematology and Oncology, UCSD Moores Cancer Center, La Jolla, California.
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Parker
authors.affiliation: Center for Personalized Cancer Therapy and Division of Hematology and Oncology, UCSD Moores Cancer Center, La Jolla, California.
authors.forename: Razelle
authors.initials: R
authors.lastname: Kurzrock
mesh_terms: D000074141:Circulating Tumor DNA / Q000097:blood* / Q000235:genetics*; D004273:DNA, Neoplasm / Q000097:blood* / Q000235:genetics; D066246:ErbB Receptors / Q000235:genetics; D005260:Female; D023281:Genomics; D059014:High-Throughput Nucleotide Sequencing / Q000379:methods; D006801:Humans; D000073890:Liquid Biopsy / Q000379:methods; D008297:Male; D008495:Medical Oncology / Q000379:methods; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood* / Q000235:genetics / Q000473:pathology*; D019869:Phosphatidylinositol 3-Kinases / Q000235:genetics; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000235:genetics; D012189:Retrospective Studies; D016159:Tumor Suppressor Protein p53 / Q000235:genetics
chemical_list: D000074141:Circulating Tumor DNA; D004273:DNA, Neoplasm; D066246:ErbB Receptors; D019869:Phosphatidylinositol 3-Kinases; D018719:Erb-b2 Receptor Tyrosine Kinases; D016159:Tumor Suppressor Protein p53