Article
Author: Gu, Wei ; Zhang, Zhihong ; Liu, Hu ; Cui, Jiuwei ; Wang, Xiuwen ; Yu, Zhuang ; Zhang, Xiaodong ; Lv, Dongqing ; Wu, Jingxun ; Yu, Jianjun ; Hu, Sheng ; Wang, Xicheng ; Han, Liang ; Zhu, Bo ; Wang, Buhai ; Yao, Yu ; Duan, Jianchun ; Wang, Ziping ; Xu, Jiachen ; Wang, Zhijie ; Zhao, Hui ; Ji, Youxin ; Zhong, Diansheng ; Cheng, Ying ; Huang, Cheng ; Li, Xingya ; Liu, Yunpeng ; Jin, Shi ; Shen, Runxi ; Wan, Rui ; Jia, Yuming ; Yang, Zhenzhou ; Zhu, Xiaoli ; Han, Baohui ; Guo, Qisen ; Cai, Yiran ; Sun, Guogui ; Liu, An-Wen ; Nie, Lei ; Song, Yong ; Li, Baolan ; Yao, Sheng ; Feng, Jian ; Han, Zhigang ; Wang, Dong ; Yang, Jun ; Yu, Yan ; Fan, Yun ; Huang, Jianjin ; Ji, Mei ; Zhou, Shaozhang ; Wu, Xiaohong ; Shi, Meiqi ; Zhang, Wei ; Zhou, Tong ; Gao, Beili ; Shi, Jianhua ; Cai, Shangli ; Wang, Qiming ; Zhou, Caicun ; Li, Xiaoling ; Yang, Xinmei ; Wang, Jie ; Shu, Yongqian ; He, Mei ; Wu, Lin ; Miao, Liyun ; Li, Qiang ; Wang, Yingyi
Stratification strategies for chemotherapy plus PD-1 inhibitors in advanced non-small-cell lung cancer (NSCLC) are critically demanded. We performed high-throughput panel-based deep next-generation sequencing and low-pass whole genome sequencing on prospectively collected circulating tumor DNA (ctDNA) specimens from 460 patients in the phase 3 CHOICE-01 study at different time points. We identified predictive markers for chemotherapy plus PD-1 inhibitor, including ctDNA status and genomic features such as blood-based tumor mutational burden, intratumor heterogeneity, and chromosomal instability. Furthermore, we established an integrated ctDNA-based stratification strategy, blood-based genomic immune subtypes (bGIS) scheme, to distinguish patients who benefit from the addition of PD-1 inhibitor to first-line chemotherapy. Moreover, we demonstrated potential applications for the dynamic monitoring of ctDNA. Overall, we proposed a potential therapeutic algorithm based on the ctDNA-based stratification strategy, shedding light on the individualized management of immune-chemotherapies for patients with advanced NSCLC.