Next Generation Sequencing for Cancer Diagnostics

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Informatics and Big Data".

Deadline for manuscript submissions: closed (15 November 2024) | Viewed by 2005

Special Issue Editor


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Guest Editor
Laboratory of Genomic Medicine, Department of Pathology, University of Illinois Chicago, Chicago, IL 60612, USA
Interests: next generation sequencing (NGS)-based assay development; diagnostic clinical oncology; genomic characterization of solid tumors and hematologic malignancies; using genomic data for patient stratification into treatment groups; monitoring response to treatment

Special Issue Information

Dear Colleagues,

Cancer is a leading cause of death worldwide, and accounted for ~10 million cancer deaths in 2020. The introduction of next-generation sequencing (NGS) technologies in clinical oncology laboratories has allowed the detection of somatic alterations, including single nucleotide variants, small indels, copy number variants and structural variants, on a genome-wide scale. Large-scale sequencing studies have illustrated the genomic landscapes of different cancers, thus leading to the identification of novel driver mutations, prognostic markers and a large number of therapeutic targets. Recent progress in genomic analysis using NGS technology has enabled the comprehensive detection of mutations, as well as the tumor mutation burden (TMB), in patient tumors, a biomarker for immunotherapy. NGS-based techniques have also been applied at the transcriptomic and epigenomic levels in order to accelerate our understanding of cancer biology and clinical trials for novel therapeutics. Precision medicine has revolutionized the therapeutic management of cancer patients, which is driven by the sequencing of circulating tumor DNA (ctDNA) from liquid biopsies. This has allowed targeted therapy to be developed, by monitoring patient responses to treatment and identifying the eventual genomic mechanisms of resistance. NGS-based technologies have played a significant role in the stratification of patients for targeted therapy based on specific molecular alterations, which are detected in the tissue biopsy or in the liquid biopsy; they have therefore become increasingly part of routine clinical practice. In this issue of Cancers, we would like to present a review of the currently available data on the utility of NGS-based applications for cancer diagnostics.

Dr. Gayatry Mohapatra
Guest Editor

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Keywords

  • next-generation sequencing
  • liquid biopsy
  • transcriptome
  • epigenome
  • targeted therapy

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Published Papers (1 paper)

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Research

16 pages, 2621 KiB  
Article
Immunotherapy Plus Locoregional Therapy Leading to Curative-Intent Hepatectomy in HCC: Proof of Concept Producing Durable Survival Benefits Detectable with Liquid Biopsy
by Roma Raj, Chase J. Wehrle, Nihal Aykun, Henry Stitzel, Wen Wee Ma, Smitha Krishnamurthi, Bassam Estfan, Suneel Kamath, David C. H. Kwon and Federico Aucejo
Cancers 2023, 15(21), 5220; https://doi.org/10.3390/cancers15215220 - 30 Oct 2023
Cited by 7 | Viewed by 1552
Abstract
Background: Immunotherapy has emerged as an improved systemic treatment for select patients with advanced unresectable HCC. Objective response is reported in 30% of patients, yet complete response (pCR) allowing for curative-intent resection is rare. Locoregional therapies (LRTs) seem to show synergistic effects with [...] Read more.
Background: Immunotherapy has emerged as an improved systemic treatment for select patients with advanced unresectable HCC. Objective response is reported in 30% of patients, yet complete response (pCR) allowing for curative-intent resection is rare. Locoregional therapies (LRTs) seem to show synergistic effects with immunotherapy, though this effect has not been scientifically reported. We report a cohort of patients showing pCR to immunotherapy + LRT as a proof of concept for the proposed treatment approach for locally unresectable HCC. Methods: Patients with unresectable HCC treated with immunotherapy as an intended destination therapy from 2016 to 2023 were included. The electronic health record was queried for oncologic information, locoregional therapies, surgical interventions, and long-term outcomes. Circulating tumor DNA (ctDNA) testing was obtained using Guardant360, and tumor mutational burden (TMB) was defined as the number of somatic mutations per megabase. Results: Ninety-six patients with advanced HCC received immunotherapy + LRT as a destination therapy. In total, 11 of 96 patients showed a complete response according to mRECIST criteria. Four of these (36.4%) ultimately underwent curative-intent resection. The median follow-up was 24.9 (IQR 15.6–38.3) months. Overall survival rates in those with complete response at 1, 3, and 5 years were 100%, 91%, and 81.8%, respectively, which were significantly improved compared to those of the cohort not achieving pCR (p < 0.001). All four patients undergoing immunotherapy + LRT followed by curative-intent hepatectomy have no evidence of disease (NED). Of those undergoing surgery, ctDNA was cleared in 75% (n = 3), providing an additional objective measurement of complete response. All four patients were TMB+ before beginning this treatment course, with three being TMB-, indicating stable and complete disease response. Conclusions: Immunotherapy + locoregional therapy can help downstage a significant proportion of patients with initially unresectable HCC, allowing for curative-intent surgery. The survival benefit associated with complete response seems durable up to 3 years after achieving this response. ctDNA measurement was converted from positive to negative in this cohort, providing additional indication of response. Full article
(This article belongs to the Special Issue Next Generation Sequencing for Cancer Diagnostics)
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