The Ideal Patient for Biomarker Testing in Anal Carcinoma

Cathy Eng, MD, FACP, FASCO, discusses the types of patients who should be tested for biomarkers in the anal cancer space.

Cathy Eng, MD, FACP, FASCO, David H. Johnson Chair in Surgical and Medical Oncology and co-leader of the Gastrointestinal Cancer Research Program, at the Vanderbilt-Ingram Cancer Center, discusses the types of patients who should be tested for biomarkers in the anal cancer space.

As of now, the role of biomarkers is largely exploratory, and the 1 biomarker that's being most heavily explored is PD-L1 expression, according to Eng. PD-L1 has been explored in multiple malignancies where immune checkpoint inhibitors are being considered.

Eng notes that for patients with locally advanced disease, there is interest in examining the role of HPV cirtulating tumor DNA due to 90% of all anal carcinoma patients being HPV positive. For anal carcinoma in particular, experts hope to derive more data from individual studies moving forward in regard to looking at immune checkpoint inhibition.

Transcription:

0:08 | For our locally advanced patients, there's definitely a lot of interest in looking at the role of HPV circulating tumor DNA, keeping in mind that 90% of all anal carcinoma patients are HPV positive. There has been some data looking at both earlier stage disease as well as metastatic disease where HPV circulating tumor DNA can correlate with response to radiation therapy as well as correlate with response to chemotherapy.

0:40 | The data that's been published thus far are in smaller studies. I am the principal investigator for our EA2176 trial [NCT04444921], which is a phase 3 trial of carboplatin plus paclitaxel plus or minus nivolumab [Opidivo] in treatment-naive metastatic patients. We are very fortunate to have received support to look at this in our patient population. I'm hoping that we can derive more information from that. Once again, I'm hoping that HPV circulating tumor DNA can become a potential standardized biomarker moving forward.