Researchers from various institutes, along with US biotech company Personalis, have found a test that can predict lung cancer outcomes by identifying circulating tumour DNA (ctDNA) in the blood.

Personnel from Francis Crick Institute (Crick), University College London (UCL), and University College London Hospital (UCLH) took part in the research. In addition, the National Institute for Health and Care Research UCLH Biomedical Research Centre supported the study, which also received funding from Cancer Research UK.

The researchers leveraged Personalis' NeXT Personal platform, which can identify ctDNA at levels as low as one part per million.

This advancement is built upon Crick's earlier work, which identified blood signals indicative of cancer cells that could signal a relapse post-treatment.

In a study involving 171 subjects with early-stage non-small cell lung cancer (NSCLC) from the TRACERx cohort, NeXT Personal demonstrated “high sensitivity” in identifying NSCLC, including 100% of non-adenocarcinomas and 81% of lung adenocarcinomas (LUAD) pre-operatively.

The researchers applied NeXT Personal to blood plasma samples from the TRACERx cohort, finding that subjects with lower ctDNA levels before surgery had “improved” survival rates and were “less likely” to experience relapse compared to those with higher ctDNA levels.

The next phase of research will evaluate the test on post-operative samples to determine if ctDNA can indicate the risk of future relapse. This could enable doctors to administer additional therapies to increase the chances of curing patients.

Crick and UCL CRUK Lung Cancer Centre of Excellence postdoctoral clinical fellow James Black said: “We’ve shown that the presence or absence of tumour DNA in the blood was strongly predictive of prognosis.

"ctDNA testing, especially using ultrasensitive platforms, could help clinicians make more informed decisions about treatment and give patients a more accurate idea of how their disease might progress. More research to validate these tests will help to get them on the agenda for regular clinical use."

Personalis noted that its NeXT Personal test uses whole-genome sequencing to create a unique signature for each patient's tumour. A personalised blood test can then identify this signature with “ultra-high sensitivity”.

Personalis R&D executive vice president and chief medical officer Richard Chen said: "We designed NeXT Personal to detect residual or recurrent cancer in its earliest stages, and this study shows the clinical importance of that ultra-sensitive detection in early-stage lung cancer.

“We look forward to continuing our work with the TRACERx team on the broader clinical performance of ctDNA testing in early-stage lung cancer.”