Graphical Summary: ctDNA response after pembrolizumab in non-small cell lung cancer: Phase 2 adaptive trial results

Circulating tumor DNA (ctDNA) can detect primary resistance to immunotherapy in patients with lung cancer. In the first stage of this phase 2 trial, we evaluated 50 patients with advanced non-small cell lung cancer who received standard of care pembrolizumab to determine ctDNA response and its concordance with imaging. The primary endpoint was achieved and showed an impressive 82% sensitivity and 75% specificity in predicting radiologic response. These findings are guiding the ctDNA driven second stage of this trial where patients at risk of early progression are randomized to treatment intensification. 

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