AstraZeneca will collaborate with ArcherDX, a genomic analysis company focused on precision oncology, to use personalized cancer monitoring to detect minimal residual disease (MRD) in patients with early-stage non-small cell lung cancer (NSCLC).
ArcherDX’s personalized assay will be used in AstraZeneca’s recently launched Phase III MERMAID-1 trial to evaluate the effect of adjuvant treatment with Imfinzi (durvalumab) plus chemotherapy versus chemotherapy alone on disease-free survival (DFS). The trial is in patients with completely resected, Stage II and III NSCLC who show evidence of MRD suggesting a high risk of relapse.
Break new ground in lung cancer
MRD describes a very small number of otherwise undetectable cancer cells that shed circulating tumor DNA (ctDNA) in the blood. Monitoring for the presence of MRD using ctDNA may provide valuable information on how well a treatment is working, inform prognosis, and detect if a patient’s cancer has returned. Ultimately, MRD detection may enable physicians to intervene earlier and tailor the best treatment options for individual cancer patients.
“While detecting and monitoring for minimal residual disease has proven challenging in solid tumors, the MERMAID-1 trial and this partnership stand to break new ground in lung cancer. This innovative endeavour is reflective of our strategy to improve cancer outcomes by treating patients as early as possible. It is in this early setting that the chance of cure is higher and identifying personalized, effective treatments could increase survival and improve quality of life,” says José Baselga, Executive Vice President of Oncology R&D, AstraZeneca.
Whole exome sequencing
Under the terms of the agreement, ArcherDX will perform whole exome sequencing of NSCLC patient samples and generate highly sensitive, personalized ctDNA assays to test for MRD that remains after a patient’s successful surgery. The ongoing development of these assays is informed by the TRACERx study, funded by Cancer Research UK and led by UCL and the Francis Crick Institute.
Imfinzi is being tested in an extensive development programme in lung cancer with several ongoing Phase III trials in earlier stages of NSCLC in potentially curative settings.
Photo of José Baselga: AstraZeneca