Dr Kato on the Role of ctDNA-Guided Therapy in RCC

“We can [use this information] to reduce the risk of [disease] recurrent in ctDNA-positive patients. [In our study], we applied a personalized, specific ctDNA panel which consisted of 1000 somatic values from whole exome sequencing data. It is not common to use whole genome sequencing but [we have seen that] it is very useful to use whole exome sequencing. The cost of whole genome sequencing is decreasing, so in the near future I believe that we can use this whole genome sequencing approach.”

Taigo Kato, MD, PhD, an assistant professor in the Department of Urology at Osaka University Graduate School of Medicine, discussed the present role of circulating tumor DNA (ctDNA)–guided therapy in renal cell carcinoma (RCC) and the utility of the whole genome sequencing panel that was evaluated in patients with resectable RCC in the prospective MONSTAR-SCREEN-3 study (UMIN000053975).

Kato noted that data from the phase 3 IMvigor011 trial (NCT04660344) showed that ctDNA status could be used to guide approaches to adjuvant therapy in patients with muscle-invasive bladder cancer. Similarly, in RCC, oncologists could use the approach in RCC to reduce disease recurrence risk by determining which patients are suitable candidates for adjuvant therapy.

Kato explained that the ctDNA panel used in MONSTAR-SCREEN-3 was individualized to each patient and contained 1000 somatic values. It is not common to use this type of whole genome sequencing panel in daily practice; however, whole exome sequencing has proven to be useful, he explained. In the near future, whole genome sequencing may be able to be used in a similar manner to whole exome sequencing as the cost of the approach is decreasing, he concluded.

Disclosures: Kato received honoraria from Bristol-Myers Squibb Japan; Merck; MSD; Pfizer; and Takeda. He also received research funding from Takeda.