S771
Clinical - Lung
ESTRO 2026
in-house developed tumor-agnostic droplet digital polymerase chain reaction (ddPCR) assays for testing methylated loci near the genes HOXA9, TFAP2B, MCIDAS, and SP9. Chi2 statistics or Fisher's exact test were used for individual markers, and receiver operating characteristic (ROC) analyses were used for the combined markers. Results: The presence of a baseline reduced NKA was significantly associated with experiencing a relapse within 12 months follow-up (p = 0.01). Having a positive baseline ctDNA status was also significantly associated with experiencing a relapse within 12 months follow-up (p = 0.03). The combination of all four ctDNA markers, sPD-L1, and NKA had an area under the curve (AUC) of 0.86 [95% CI 0.74-0.98] for predicting a relapse within 12 months of follow-up. Figure 1 shows the different AUC’s for the different combinations of markers.
Unrecognized Complication of Radiation Therapy. AJR Am J Roentgenol. 2020;215(6):1329-34.2. Baranga L, et al. In Situ Pulmonary Arterial Thrombosis: Literature Review and Clinical Significance. AJR Am J Roentgenol. 2023;221(1):57-68.3. Kong FS, et al. Primary Results of NRG-RTOG1106/ECOG-ACRIN 6697. J Clin Oncol. 2024 Nov 20;42(33):3935-3946.4. Carver JR, et al.; ASCO Cancer Survivorship Expert Panel. cardiac and pulmonary late effects. J Clin Oncol 2007; 25:3991– 40085. Ma JT, et al. Is pulmonary artery a dose-limiting organ at risk in non-small cell lung cancer patients? Radiat Oncol. 2017 Feb 1;12(1):34.6. Socinski MA, et al. PACIFIC trial. Clin Lung Cancer. 2021;22(6):549-61. Keywords: In situ pulmonary artery thrombosis, NSCLC, RT The prognostic value of methylated ctDNA, soluble PD-L1, and NK-cell activity on the risk of relapse after curative radiotherapy of NSCLC. Thomas Leth Fink 1,2 , Rikke Fredslund Andersen 1,3 , Cecilie Mondrup Jacobsen 1,3 , Line Nederby 1,3 , Mads Malik Aagaard Jørgensen 4 , Charlotte Kristiansen 1 , Torben Schjødt Hansen 1 , Sara Witting Christensen Wen 3,2 , Christa Haugaard Nyhus 1 , Rune Slot Thing 1 , Signe Timm 1,2 , Torben Frøstrup Hansen 1,2 1 Department of Oncology, Lillebaelt Hospital, Vejle, Denmark. 2 Institute for Regional Health Research, University of Southern Denmark, Odense, Denmark. 3 Department of Biochemistry and Immunology, Lillebaelt Hospital, Vejle, Denmark. 4 Department of Clinical Genetics, Lillebaelt Hospital, Vejle, Denmark Digital Poster 1458 Purpose/Objective: Despite receiving curative radiotherapy (RT) for localized lung cancer, relapse may occur within the first year, and 5-year survival is low. The use of prognostic biomarkers might help identify patients at higher risk of relapse and offer them further treatment such as adjuvant immune checkpoint inhibitors or closer follow-up after completion of the curative RT. In this study, we evaluated the prognostic ability of the combination of Natural Killer-cell activity (NKA), soluble programmed death-ligand 1 (sPD-L1), and circulating tumor DNA (ctDNA) to predict a relapse within 12 months follow-up after curative RT. Material/Methods: Sixty-eight patients treated with either stereotactic body radiation therapy or long-course RT for non- small cell lung cancer (NSCLC) had blood samples analyzed from baseline, the first follow-up visit, and 6 and 9 months after treatment. NKA was measured with the NKVue® assay using Interferon-gamma as a surrogate for NKA, sPD-L1 was measured with the Quantikine ELISA kit, and ctDNA was measured using
Figure 1. Stepwise ROC analyses of baseline biomarkers and the risk of relapse within 12 months follow-up Conclusion: Findings from this study suggest that a combination of all six biomarkers measured at baseline may help predict the risk of relapse following curative RT for NSCLC. The baseline NKA and baseline methylated ctDNA status was also significantly associated with the risk of relapse, but due to small sample size, larger studies with longer follow-up are needed to further
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