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Pharma Tech Outlook | Tuesday, March 08, 2022
Researchers who treated a group of post-surgery bladder cancer patients with the immunotherapy drug atezolizumab have found that patients whose blood contained circulating tumour DNA (ctDNA), responded very well to the treatment.
FREMONT, CA: Individuals whose blood contained circulating tumour DNA (ctDNA) respond very well to the treatment when given the immunotherapy medicine atezolizumab after having surgery for bladder cancer. The study, which indicated the aforementioned results, was a component of the larger Phase III trial IMvigor010, which examined whether prolonging atezolizumab treatment after bladder removal surgery for up to a year increased patients' chances of surviving, as opposed to a control group that underwent the procedure without any additional care and was placed in an observation group. In that trial, patients' ctDNA levels were monitored before surgery, throughout recovery, and during follow-up care. Although the trial's intention-to-treat population did not reveal a significant difference in overall survival between the two groups, the researchers did note that a subgroup of ctDNA-positive patients had a substantial improvement after receiving atezolizumab. These advantages included considerably greater overall survival and disease-free survival compared to the observation group. Patients who did not have ctDNA did not experience this impact. The researchers also discovered that individuals who initially had ctDNA positivity but later switched to ctDNA negativity after receiving atezolizumab had a very favourable prognosis.
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ctDNA is made up of DNA fragments that have been released into the bloodstream by tumours and malignant cells. Although it has become a potential, minimally invasive biomarker in clinical oncology, it isn't yet commonly utilised as a standard diagnostic and treatment tool for any tumours. It is sometimes referred to as a liquid biopsy. Every patient's tumour-specific genes must be sequenced, which takes time and is currently rather expensive. In the future, the normal treatment pathway may change, which would lower the average cost of ctDNA analysis. If it is possible to demonstrate that subsequent therapeutic activity is linked to ctDNA status and that high-risk patients will benefit from it, then it is likely to do so. The forthcoming IMvigor 011 research, which has been revised in light of these findings, will be the next stage. The 500-person trial will compare atezolizumab to placebo in exclusively ctDNA-positive patients after surgery and will further assess the utilisation of ctDNA sampling.
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