There is a critical need to identify MRD to determine which patients benefit from checkpoint inhibitor therapy and to optimize and personalize the duration of consolidation Durvalumab. The long-term goal is to incorporate ctDNA analysis into clinical practice to individualize therapy in patients with stage III NSCLC by moving to a treatment-by-marker based approach (as opposed to treatment based on clinical or radiographic evidence of disease). This approach may spare a subset of patients from treatment with unnecessarily excessive cycles of consolidation immunotherapy if they are already cured with CRT alone and individualize the duration of consolidation immunotherapy in patients not cured with CRT. The study team also seek to identify early in the treatment course, patients who are destined not to be cured with consolidation immunotherapy so that alternative strategies can be tested when tumor burden is low.
Inclusion Criteria:
Age ≥ 18 years
Ability to provide written informed consent and HIPAA authorization
Patients with inoperable or unresectable stage III NSCLC who are planning to receive
concurrent CRT followed by consolidation Durvalumab OR Patients with inoperable or
unresectable stage III NSCLC who have previously received concurrent CRT and are planning
or currently receiving C1-4 consolidation durvalumab
Must have viable tissue for ctDNA profiling, (fresh or archived tissue)
Exclusion Criteria:
Patient unwilling to provide tissue and blood samples for ctDNA testing.
Patient has contraindications to treatment with concurrent CRT and/or consolidation
Durvalumab.
Patients with any other active cancer; excluding squamous cell or basal cell cancer.
Indiana University (IU)
- Eskenazi Hospital
- IU Health West
- Indiana University Hospital / IU Simon Cancer Center
Roudebush VA Medical Center
- Roudebush VA Medical Center