Abstract
NeoGenomics has added a new next-generation sequencing (NGS) assay to its lineup of oncology tests: RaDaR™. For insight into this new technology and how it's set to transform care for cancer patients, Inside Precision Medicine turned to the Chief Medical Officer of Clinical Services at NeoGenomics, Dr. Derek Lyle, for some answers.
RaDaR™ stands for “residual disease and recurrence.” It's a liquid biopsy test assay used to identify MRD (minimal residual disease) in patients with solid tumors.
MRD testing in certain hematologic cancers has been mainstream for a number of years now; however, in the setting of solid tumors, it is very new. This is an exciting area of cancer testing, and we believe, with the sensitivity RaDaR provides, it is one of the best choices—if not the best choice—on the market.
RaDaR has extremely high analytical sensitivity, which means it can detect trace amounts of ctDNA (small fragments of tumor DNA circulating in the peripheral blood) at low levels. The high sensitivity of the assay is achieved, in part, because it is “tumor-informed,” which means the liquid biopsy is designed specifically from the patient's tumor, analyzing up to 48 tumor-specific variants. Let me unpack that a little more.
We start by performing whole-exome sequencing on the patient's biopsy or resection sample, which will identify multiple tumor-associated genomic alterations, or variants. Next, we design a “personalized” liquid biopsy assay which will specifically look only for those unique variants that we know are present in the patient's tumor. In each and every patient tested, we will be looking for a unique set of variants.
This is different from assays that are not tumor-informed and instead look for a “fixed” set of variants in all patients, which an individual patient's tumor may or may not actually have.
RaDaR is useful for patients being treated for solid tumor malignancies, such as breast, lung, and colorectal cancer, although we are likely to see it used in many others in addition.
There are multiple timepoints in a cancer patient's treatment journey where RaDaR may be useful.
Early-stage patients will be tested in the weeks following curative-intent therapy, which will determine whether residual disease is present following that therapy. In some patients, it may be useful to test before that therapy, in order to verify the tumor is shedding ctDNA into the blood, as this will be an important baseline for future tests.
Some patients may also be tested serially over time to monitor for molecular recurrence. The presence of ctDNA in this setting predicts eventual clinical recurrence. Studies we have conducted demonstrate detection of ctDNA months in advance of clinical recurrence with RaDaR.
We have just published some great peer-reviewed studies, both in lung and in head and neck cancers, the LIONESS and LUCID studies, respectively, and there's more data to come in the next key conferences this year. These studies demonstrate a couple of key findings.
First, presence of ctDNA following curative-intent therapy is associated with a much higher risk of recurrence.
Second, serial monitoring of patients following curative-intent therapy and/or adjuvant therapy has the potential to identify molecular recurrence months in advance of clinical recurrence.
These findings suggest the potential for therapeutic interventions at these various testing timepoints, as well as the potential benefit of avoiding therapeutic interventions, such as adjuvant chemotherapy, when they would not have clinical benefit.
NeoGenomics has always been a leader in oncology testing. By adding RaDaR to our portfolio of high-quality oncology-focused assays, we're providing oncologists with another test that has the potential to significantly change patient care.
