Extended Data Fig. 10: Pre-surgery ctDNA dynamics and association with progression-free and overall survival. | Nature Medicine

Extended Data Fig. 10: Pre-surgery ctDNA dynamics and association with progression-free and overall survival.

From: Perioperative nivolumab or nivolumab plus ipilimumab in resectable diffuse pleural mesothelioma: a phase 2 trial and ctDNA analyses

Extended Data Fig. 10

(a) At the pre-surgery timepoint, patients who had ≥95% reduction in cfDNA TF or undetectable ctDNA throughout neoadjuvant treatment (n = 12) had numerically longer -though not statistically significant- OS compared to patients who had <95% reduction in cfDNA TF (n = 11), with a median OS of 27.73 versus 15.47 months (log-rank test, p = 0.065; HR = 0.39, 95% CI: 0.14−1.1). (b) Amongst the subset of patients who completed surgery, those who had ≥95% reduction in cfDNA TF or undetectable ctDNA throughout neoadjuvant treatment (n = 12) had significantly longer PFS compared to patients with <95% reduction in cfDNA TF (n = 5), with a median PFS of 23.26 versus 7.26 months (log-rank test, p = 0.0063; HR = 0.2, 95% CI: 0.05 − 0.71). (c) At the pre-surgery timepoint, patients in Arm A who underwent surgery and had ≥95% reduction in cfDNA TF or undetectable ctDNA throughout neoadjuvant treatment (n = 5) had significantly longer PFS compared to patients who had <95% reduction in cfDNA TF (n = 3), with a median PFS of 17.25 versus 7.26 months (log-rank test, p = 0.0042; HR not estimable). (d) At the pre-surgery timepoint, patients who underwent surgery and had ≥95% reduction in cfDNA TF or undetectable ctDNA throughout neoadjuvant treatment (n = 12) had significantly longer OS compared to patients who had <95% reduction in cfDNA TF (n = 5), with a median OS of 27.73 versus 14.95 months (log-rank test, p = 0.031; HR = 0.22, 95% CI: 0.05 − 0.99). (e) At the pre-surgery timepoint, patients in Arm A who underwent surgery and had ≥95% reduction in cfDNA TF or undetectable ctDNA throughout neoadjuvant treatment (n = 5) had numerically longer -though not statistically significant- OS compared to patients who had <95% reduction in cfDNA TF (n = 3), with a median OS of 26.87 versus 14.95 months (log-rank test, p = 0.12; HR = 0.26, 95% CI: 0.04 − 1.61). Abbreviations: pre-surg, pre-surgery; ctDNA, circulating tumor DNA; cfDNA, cell-free DNA; TF, tumor fraction; UD, undetectable; OS, overall survival; PFS, progression-free survival; HR, hazard ratio; CI, confidence interval.

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