This test was included in the oral report of the American Society of Clinical Oncology, which detected tumor recurrence and metastasis earlier than imaging | Tumor | United States
At the 2023 Annual Meeting of the American Society of Clinical Oncology, a research achievement jointly conducted by Shanghai Precision Medical Enterprise Zhiben Medical and Professor Yin Junqiang from the Department of Orthopedics and Oncology at the First Affiliated Hospital of Sun Yat sen University, titled "The Clinical Value of Individualized Customized Small Residual Lesion Detection in Sarcoma", was selected for the oral report of the Clinical Science Seminar, becoming the only Chinese achievement selected for the Clinical Science Seminar. Research has shown that personalized customized MRD testing can predict the recurrence of sarcoma earlier than imaging, and can be used to predict the efficacy of preoperative neoadjuvant therapy.
Sarcoma originates from mesenchymal tissue and often occurs in the skin, subcutaneous tissue, periosteum, and both ends of the long bone. Osteosarcoma is more common in young patients and is more common at both ends of the long bones in the limbs, especially at the lower end of the femur, upper end of the tibia, and upper end of the humerus. Common sarcomas include leiomyoma, lymphosarcoma, synovial sarcoma, etc., all of which belong to malignant tumor lesions.
Professor Yin Junqiang and Zhiben Medical conducted a collaborative study on 84 sarcoma patients through personalized and customized MRD dynamic monitoring. The overall success rate of customizing MRD "test kits" was 78.6%. The research results show that more than half of sarcoma patients have unique tumor mutation genes, and these patients are more suitable for personalized and customized MRD dynamic monitoring. In baseline testing, 100% of circulating tumor DNA can be detected, and postoperative MRD detection results can indicate the recurrence and metastasis of sarcoma earlier than imaging.
Professor Yin Junqiang gave a presentation at the 2023 ASCO Annual Conference.
This study has brought important progress to the dynamic monitoring and efficacy prediction of MRD in sarcoma. In recent years, with the development of precision therapy, MRD detection based on free DNA has become a focus of clinical attention. The so-called free DNA refers to the DNA in the circulating blood that is free outside the cell. This detection method has the characteristics of high sensitivity and specificity, and can sensitively capture the clues in free DNA, thus detecting tumor recurrence earlier than traditional imaging techniques. Therefore, the dynamic monitoring and efficacy prediction of MRD in sarcoma is an excellent prognostic indicator.
Among the 84 sarcoma patients included in the study, soft tissue sarcoma accounted for 38%, bone tumors accounted for 58%, and 4% were undifferentiated sarcoma. Through whole exome detection, a total of 13577 mutations were detected in these patients, covering 7715 genes, of which 64% were unique to individual patients, indicating heterogeneity in sarcoma patients.
Five patients tested positive for MRD after surgery, indicating recurrence and metastasis earlier than imaging monitoring; The MRD test results of three other patients were consistent with the confirmed recurrence and metastasis on imaging.
At the annual meeting of the American Society of Clinical Oncology, Yin Junqiang also introduced the patient follow-up situation: two patients were found to have pulmonary nodules before surgery, and postoperative MRD dynamic monitoring showed positive results, suspected of pulmonary metastasis. These two patients underwent imaging monitoring in September and October last year, respectively, and the results confirmed that the nodules were enlarged, while the circulating tumor DNA showed an upward trend. These two cases suggest that MRD can assist in predicting the occurrence of metastatic lesions and the progression after treatment.
Based on this, the research team suggests that, on the basis of routine CT follow-up after surgery, more sensitive and frequent MRD detection can be carried out through liquid biopsy peripheral blood MRD detection technology, in order to achieve early warning of recurrence and metastasis, and provide reference for adjusting clinical treatment strategies for patients.