ASCO 2023 | EMPOWER-Lung 1: ctDNA as a biomarker for treatment responses in NSCLC

Natalie Vokes, MD, The University of Texas MD Anderson Cancer Center, Houston, TX, discusses the EMPOWER-Lung 1 trial (NCT03088540), which investigated cemiplimab versus chemotherapy in patients with advanced, PD-L1-high non-small-cell lung cancer (NSCLC). The aim of the study was to assess the use of circulating tumor DNA (ctDNA) dynamics to understand immunotherapy responses. A clear bimodal distribution was witnessed in the immunotherapy cohort. In the chemotherapy cohort, many patients ctDNA reduced, but there was markedly less complete clearance. Patients who had a complete clearance of ctDNA had better long-term outcomes in terms of progression-free survival (PFS) and overall survival (OS). In terms of radiographic response assessments, dynamics correlated with either partial response or progressive disease. However, patients with stable disease either saw a rise or a fall in ctDNA levels. These patients could be categorized based on their ctDNA levels. Therefore, this study highlights the use of ctDNA as a biomarker in the assessment of immunotherapy responses; however, these trends are not as strong for chemotherapy. This interview took place at the American Society of Clinical Oncology (ASCO) 2023 Annual Congress in Chicago, IL.

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