Prognostic significance of circulating tumor DNA alterations in advanced renal cell carcinoma from SCRUM-Japan MONSTAR-SCREEN: a nationwide genomic profiling project.
Kato T., Shiota M., Nishimoto K., Matsubara N., Osawa T., Abe T., Yasumizu Y., Tanaka N., Yamamoto Y., Ishizuya Y., Abutani H., Bando H., Fujisawa T., Nakamura Y., Oya M., Shinohara N., Eto M., Yoshino T., Nonomura N.
BackgroundCirculating tumor DNA (ctDNA) is a promising tool for diagnosing and predicting cancer prognosis. However, its clinical utility in metastatic renal cell carcinoma (mRCC) remains unclear, particularly in terms of clinical prognosis.MethodsWe enrolled 124 patients with mRCC in the MONSTAR-SCREEN study (UMIN 000036749) between August 2019 and February 2022, a national observational ctDNA-based screening study, and performed ctDNA sequencing before and at the time of resistance to systemic therapy.ResultsctDNA were assessed in 178 samples containing 432 mutations. The most frequently altered genes at baseline were VHL (25.0%), PBRM1 (10.9%), TERT2 (8.7%), BAP1 (8.7%), and MTOR (7.6%). Patients receiving first-line therapy with tumor fraction (TF) ConclusionsOur findings demonstrated that ctDNA profiling is feasible in mRCC and can predict disease progression after treatment.