Jessica Ganga

GI Oncology Now

A team of researchers investigated the association of pretreatment circulating tumor DNA (ctDNA) burden in patients with gastric cancer (GC) with treatment results among patients with metastatic GC (mGC) treated with first-line therapies. Their analysis found that the presence of a high pretreatment ctDNA burden was associated with worse clinical outcomes in this patient population, <a href="https://ascopubs.org/doi/abs/10.1200/PO-24-00582" target="_blank" rel="noopener">as reported in their published study</a>.Researchers used the GuardantINFORM real-world clinical-genomic database to identify adult patients with mGC who underwent testing with the Guardant360 assay between June 2014 and March 2022. The testing was conducted 50 days before the initiation of first-line treatment. The study team classified patients into high- or low-ctDNA burden groups using the median of maximum variant allele fraction (MVAF). Patients with undetectable ctDNA burden were included in the low-burden group.Real-world outcome measures, including time to treatment discontinuation (rwTTD), time to next treatment (rwTTNT), and overall survival (rwOS), were assessed through log-rank testing and multivariable Cox proportional hazards modeling.A total of 824 patients with mGC were included in the study. The median MVAF was 2.9%, with 91% of patients having detectable ctDNA. Of the total, 537 patients received chemotherapy-based treatment, 100 patients received immunotherapy, and 99 received trastuzumab-based treatment.Researchers observed that, among patients who received chemotherapy, rwTTDs were similar in low and high ctDNA burden groups. Those with high ctDNA burden showed shorter rwTTNT and rwOS (median rwTTNT=4.8 months vs 7.4 months; P&lt;0.001; median rwOS=13.2 months vs 19.1 months; P&lt;0.001).For patients who received immunotherapy and trastuzumab-based treatment, multivariable Cox analyses were applied and showed similar ctDNA burden results. They did not have significant associations with outcomes.&ldquo;We used RWD to demonstrate that high pretreatment ctDNA burden was associated with worse clinical outcomes in a mGC population receiving 1L chemotherapy-based treatments,&rdquo; the researchers concluded. &ldquo;Our analysis suggests ctDNA burden could be used as a prognostic biomarker for mGC.&rdquo;
<div class="post-references"><h3>References</h3>Peter SA, Cristescu R, Peña C, et al. Assessment of Circulating Tumor DNA Burden in Patients With Metastatic Gastric Cancer Using Real-World Data. JCO Precis Oncol. Published online May 2025. doi: <a href="https://pubmed.ncbi.nlm.nih.gov/40324115/" target="_blank" rel="noopener">10.1200/PO-24-00582</a>
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Circulating tumor DNA burden in patients with gastric cancer may aid oncologists in determining treatment options. 