000			01677cam a2200169 4500
001			NMDX7306
008			120401t2017 xxu||||| |||| 00| 0 eng d
100			_aAnand, G.
240			_aNature
245			_aPhylogenetic ctDNA analysis depicts early stage lung cancer evolution
260			_c2017
500			_aNMUH Staff Publications
500			_a545
520			_a<span style="font-size: 10pt;">The early detection of relapse following primary surgery for non-small cell lung cancer and the characterization of emerging subclones seeding metastatic sites might offer new therapeutic approaches to limit tumor recurrence. The potential to non-invasively track tumor evolutionary dynamics in ctDNA of early-stage lung cancer is not established. Here we conduct a tumour-specific phylogenetic approach to ctDNA profiling in the first 100 TRACERx (TRAcking non-small cell lung Cancer Evolution through therapy (Rx)) study participants, including one patient co-recruited to the PEACE (Posthumous Evaluation of Advanced Cancer Environment) post-mortem study. We identify independent predictors of ctDNA release and perform tumor volume limit of detection analyses. Through blinded profiling of post-operative plasma, we observe evidence of adjuvant chemotherapy resistance and identify patients destined to experience recurrence of their lung cancer. Finally, we show that phylogenetic ctDNA profiling tracks the subclonal nature of lung cancer relapse and metastases, providing a new approach for ctDNA driven therapeutic studies.</span>
856			_uhttps://www.ncbi.nlm.nih.gov/pubmed/28445469
856			_uhttp://ferriman.wufoo.com/forms/journal-article-request/
999			_c76254 _d76254