MRD-Routine
Research type
Research Study
Full title
Prospective study of minimal residual disease (MRD) in routine follow up of radically treated non-small cell lung cancer patients
IRAS ID
309525
Contact name
Sanjay Popat
Contact email
Sponsor organisation
The Royal Marsden NHS Foundation Trust
Duration of Study in the UK
5 years, 0 months, 1 days
Research summary
Approximately 40% of non-small cell lung cancer (NSCLC) patients present with locoregional/early lung cancer. For patients who can have their cancer removed surgically, the use of post operative chemotherapy is standard practice to reduce cancer recurrence risk. However, the benefit of this chemotherapy is modest with a 5% improvement in survival at 5 years.
Patients who are not suitable for a surgical resection of their lung cancer are treated with a combination of chemotherapy-radiotherapy (CRT). A subset of patients are eligible for consolidative immunotherapy post CRT.
Even with these advances, most lung cancer patients will ultimately experience disease recurrence. Biomarkers are needed to help identify patients that are at high risk of cancer recurrence.
Circulating tumour DNA (ctDNA) occurs when DNA from tumour cells are present in blood. Assessing ctDNA is already routinely used in the management of patients with advanced (metastatic) lung cancer.
Minimal residual disease (MRD) is a term that describes the presence of ctDNA molecules in a patient’s blood following radical (curative intent) treatment of cancer. Retrospective studies have shown that the detection of MRD in patients who have had radical therapy for early lung cancer is associated with poorer cancer outcomes, when compared with patients without detectable residual disease.
MRD can be measured by two tests. The “Tumour informed test” assesses the mutations in the patient’s lung cancer specimen to design a personalised ctDNA test. This specific test is then used to analyse the patients blood during follow up for MRD.
A “Tumour naïve test” uses a premade, non-patient-specific, test to analyse the patients blood to look for MRD.The purpose of this study is to prospectively describe evaluating MRD status during routine follow up of radically treated stage II-III NSCLC patients in a real-world setting. Patients will have MRD assessed with either a tumour genotype informed or tumour genotype naïve assay.
REC name
London - Hampstead Research Ethics Committee
REC reference
23/LO/0021
Date of REC Opinion
20 Feb 2023
REC opinion
Further Information Favourable Opinion