Molecular Residual Disease Analysis May Predict Disease Recurrence After Lung Cancer Resection

TUESDAY, March 25, 2025 (HealthDay News) — For patients with resected stage IB-IIIA epidermal growth factor receptor-mutated non-small cell lung cancer, molecular residual disease (MRD) precedes disease-free survival (DFS) events in patients receiving osimertinib treatment or placebo and can be used to predict disease recurrence, according to a study published online March 17 in Nature Medicine.

Roy S. Herbst, M.D., Ph.D., from Yale School of Medicine and Yale Cancer Center in New Haven, Connecticut, and colleagues examined whether tumor-informed, circulating tumor DNA-based MRD could predict recurrence in a post-hoc analysis of 220 patients from the phase 3 ADAURA trial (112 received osimertinib; 108 received placebo).

The researchers found that MRD preceded imaging DFS events by a median of 4.7 months in this study. At 36 months, the DFS and MRD event-free rate was 86 versus 36 percent for patients in the osimertinib and placebo groups (hazard ratio, 0.23). DFS or MRD events were detected in 25 percent of patients (28 patients) in the osimertinib group; most events occurred after cessation of osimertinib (19 of 28 events; 68 percent) and within 12 months of stopping osimertinib (11 of 19 events; 58 percent). The DFS and MRD event-free rate was 66 percent at 24 months after osimertinib.

“Plasma-based, tumor-informed MRD analysis may predict disease recurrence during adjuvant treatment and during posttreatment follow-up,” the authors write. “MRD monitoring may inform clinical intervention, including restarting or intensifying treatment.”

Several authors disclosed ties to the biopharmaceutical industry.

Abstract/Full Text