AstraZeneca is teaming up with genomic analysis group ArcherDX to use personalised cancer monitoring to detect minimal residual disease (MRD) in patients with early-stage non-small cell lung cancer (NSCLC).

ArcherDX’s personalised assay will be used in AstraZeneca’s recently launched Phase III MERMAID-1 trial to evaluate the effect of adjuvant treatment with Imfinzi (durvalumab) plus chemotherapy versus chemotherapy alone on disease-free survival (DFS). The trial is assessing the drug in patients with completely resected, Stage II and III NSCLC who show evidence of MRD suggesting a high risk of relapse.

MRD describes a very small number of otherwise undetectable cancer cells that shed circulating tumour DNA (ctDNA) in the blood, and monitoring for its presence could provide valuable information on treatment efficacy as well as inform prognosis and detect if a patient’s cancer has returned.

The firms' partnership will see ArcherDX perform whole exome sequencing of NSCLC patient samples and generate highly sensitive, personalised ctDNA assays to test for MRD that remains after a patient’s successful surgery. The ongoing development of these assays is informed by the TRACERx study, funded by Cancer Research UK and led by UCL and the Francis Crick Institute.

“MERMAID-1 is a novel randomised trial using ctDNA to identify patients at high risk of recurrence after surgery who may benefit from intervention with immunotherapy. We hope this approach will lead to better patient outcomes by intensifying treatment for patients most likely to relapse, while avoiding additional chemotherapy after surgery when not needed,” said Charles Swanton, Professor at UCL and the Francis Crick Institute, chief clinician at Cancer Research UK, leader of Tracking Cancer Evolution through Therapy (Rx) (TRACERx) and international coordinating investigator in the MERMAID-1 trial.

“While detecting and monitoring for minimal residual disease has proven challenging in solid tumours, the MERMAID-1 trial and this partnership stand to break new ground in lung cancer,” added AZ' executive vice president of Oncology R&D José Baselga. “This innovative endeavour is reflective of our strategy to improve cancer outcomes by treating patients as early as possible. It is in this early setting that the chance of cure is higher and identifying personalised, effective treatments could increase survival and improve quality of life.”

Financial terms of the deal were not revealed.