tbuckley/cabot-search huggingface dataset:
Effectiveness of application of case management for hypertension in the elderly
Authors: 任延平, 黄若文, 韩亚利
Journal: BMJ (2010)

Objective To explore application of case management for hypertension in the elderly.Methods In total, 106 elderly patients with hypertension treated at outpatient and inpatient departments of the First Affiliated Hospital of Xian Jiaotong University were recruited during January to October 2007, and divided randomly into two groups, one with conventional management and the other with case management.Patients with conventional treatment accepted routine diagnostic and therapeutic procedures and were followed-up passively, and patients with case management accepted integrated therapy and active interview provided by a team with a cardiovascular specialist as core, were followed-up actively and their medical records were kept in files. Percentage of the patients with blood pressure lowered to meet criteria of effectiveness and their improvement in depression and anxiety status and quality of life were evaluated two years after management for the two groups. Results Percentage of patients with their blood pressure lowered to meet effective criteria increased significantly in both of the groups, from 32. 8% to 67.5% in patients with conventional management and from 33.7% to 83.4% in those with case management ( P = 0. 007 ),respectively. Scores of self-rating anxiety scale ( SAS) and self-rating depression scale (SDS) decreased in patients of the both groups, from 57 ± 10 and 56 ± 11 before management to 40 ±9 and 48 ± 10 after it,respectively in patients of conventional management ( P = 0. 032 ), and from 56 ± 10 and 57 ± 10 before management to 35 ±9 and 40 ± 9 after it ( P = 0. 008 ), respectively in those with case management; and scores of quality of life improved in patients of the two group, from 65 ± 13 before management to 85 ± 14 after it in those with conventional management, and from 64 ± 13 before management to 98 ± 14 after it in those with case management ( P = 0.017 ), respectively. Conclusions Case management is better for chronic diseases and recommended in management for the elderly with hypertension, which can improve their targets of blood pressure lowering, decrease their scores of SAS and SDS and improve their quality of life,with an integrated, in-depth, continuous management.

Key words: 
Hypertension ;  Disease management ;  Evaluation ;  Elderly ;
Immortal time bias in the association between toxicity and response for immune checkpoint inhibitors: A systematic review and meta-analysis.
Authors: Filippo G. Dall'Olio, Alessandro Rizzo, Veronica Mollica, Maria Massucci, Ilaria Maggio, Francesco Massari
Journal: Journal of Clinical Oncology (2020)

e15080 Background: A number of studies have addressed the association between Immune related Adverse Events (IrAE) and outcome in patients treated with Immune Checkpoint Inhibitors (ICI). Only a minority of them considered the effect of immortal time bias (ITB), and results of these papers are conflicting. The aim of our meta-analysis was to assess the relationship between IrAE and outcomes for patients treated with ICIs, with a focus on ITB in weighing the role of this association. Methods: PubMed, Embase (Ovid), and Scopus were searched through January 2, 2020. Studies reporting the prognostic impact of IrAE development on outcome in advanced cancer patients treated with anti PD-1 or PD-L1.Two investigators independently extracted data from each study following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guideline. Author name, cancer type, PD-1 and PD-L1 inhibitor used, number of patients, number and type of all adverse events, presence of a landmark analysis, median OS and PFS and difference between patient with or without IrAE in terms of OS and PFS (Hazard Ratio) and ORR (Odds Ratio) were extracted. Data were pooled using a random-effects model. Main outcome were Overall Survival (OS), Progression Free Survival (PFS) and Overall Response Rate (ORR). Analysis was performed with dedicated software (R studio version 1.2.1335, metafor package). Results: A total of 29 articles comprising 7430 patients were included. 7 papers published the results of survival analysis according to landmark analysis, 2 papers published only the naïve analysis while stating that a landmark analysis resulted non significant, and the others did not perform a landmark analysis. IrAEs were associated with improved outcomes with high heterogeneity ( I 2 70.8%, p &lt; 0.001 for OS; 65.7%, p 0.002 for PFS; 62.1%, p 0.001 for ORR). When subgroup analysis was performed according to the adoption of a landmark approach, the association between IrAE and outcome remains significant for OS, PFS and ORR but the effect size was smaller ( HR 0.61 vs 0.41 for OS, ANOVA Q-test for difference between subgroup p = 0.015; HR 0.66 vs 0.47 for PFS, ANOVA Q-test p 0.029; OR 2.59 vs 6.77 for ORR, ANOVA Q-test p &lt; 0.001) while heterogeneity was substantially reduced (I 2 for papers using LM 43% for OS, p 0.115; 9.7% for PFS, p 0.355; 0.0% for ORR, p 0.556). Conclusions: Our analysis suggests a significant confounding effect of ITB as well as a real effect of IrAE development on outcome.
Deep immune profiling of patients treated with lenalidomide and dexamethasone with or without daratumumab
Authors: Tineke Casneuf, Homer C. Adams, Niels W.C.J. van de Donk, Yann Abraham, Jaime Bald, Greet Vanhoof, Koen Van der Borght, Tina Smets, Brad Foulk, Karl C. Nielsen, Joshua Rusbuldt, Amy Axel, Andrew Lysaght, Hugo Ceulemans, Frederik Stevenaert, Saad Z. Usmani, Torben Plesner, Herve Avet-Loiseau, Inger Nijhof, Tuna Mutis, Jordan M. Schecter, Christopher Chiu, Nizar J. Bahlis
Journal: Leukemia (2020)

Abstract CD38-targeted antibody, daratumumab, is approved for the treatment of multiple myeloma (MM). Phase 1/2 studies GEN501/SIRIUS revealed a novel immunomodulatory mechanism of action (MOA) of daratumumab that enhanced the immune response, reducing natural killer (NK) cells without affecting efficacy or safety. We further evaluated daratumumab’s effects on immune cells in whole blood samples of relapsed/refractory MM patients from both treatment arms of the phase 3 POLLUX study (lenalidomide/dexamethasone [Rd] or daratumumab plus Rd [D-Rd]) at baseline (D-Rd, 40; Rd, 45) and after 2 months on treatment (D-Rd, 31; Rd, 33) using cytometry by time-of-flight. We confirmed previous reports of NK cell reduction with D-Rd. Persisting NK cells were phenotypically distinct, with increased expression of HLA-DR, CD69, CD127, and CD27. The proportion of T cells increased preferentially in deep responders to D-Rd, with a higher proportion of CD8 + versus CD4 + T cells. The expansion of CD8 + T cells correlated with clonality, indicating generation of adaptive immune response with D-Rd. D-Rd resulted in a higher proportion of effector memory T cells versus Rd. D-Rd reduced immunosuppressive CD38 + regulatory T cells. This study confirms daratumumab’s immunomodulatory MOA in combination with immunomodulatory drugs and provides further insight into immune cell changes and activation status following daratumumab-based therapy.
手术患者术前禁食禁饮时间延长原因分析及护理对策
Authors: 孙芹, 刘伟, 李岩冰, 黄春艳, 刘晶
Journal: BMJ (2005)

择期手术成年患者术前禁食12h、禁饮4 h作为预防术中反流误吸的重要措施[1],已沿用数年,但这种方法近几年受到质疑.因为长时间禁食、禁水增加患者口渴、焦虑、脱水、低血糖、低血容量等的发生率,直接影响麻醉手术的安全性及患者术前的舒适度,甚至使手术延期.我们2000年12月至2004年6月采用个别交谈的方式调查了158例手术患者术前禁食、禁饮情况,现报告如下。
Effect of Cilazapril on cytokines and cardiac function in patients with congestive heart failure
Authors: Li-juan Shen, Guo-ping He, Chuan-ping Qi, Jian-qiang Xiao, Bo Xu, Jun Gu, Guo-ying Yang
Journal: BMJ (2008)

Thirty seven patients with congestive heart failure (CHF) were divided into cilazapril group (n=19) and general treatment group (n=18). Serum levels of interleukin-6 (IL-6) ,interleukin-8 (IL-8) , interleukin-10(IL-10) and tumor necrosis factor-α(TNF-α) , left ventricular ejection fraction (LVEF) ,left ventricular end-diastolic diameter (LVEDD), cardiac output (CO) and fractional shortening (FS) were measured before and after treatment. Serum levels of cytokines were also measured in 40 healthy individuals (control group). Results: The serum levels of IL-6, IL-8, IL-10 and TNF-α in CHF patients were significantly higher than those in the control group ( all P<0.01 ) ; After treatment, the serum IL-6, IL-8 and TNF-α were significantly decreased (P<0.01 ,P<0.05 ) in the cilazapril group. The LVEF, FS, CO were significantly increased in the Cilazapril group ( P<0.01 ) ; And the serum levels of IL-6 were significantly decreased in the cilazapril group as compared with the general treatment group ( P<0.05 ), however, after treatment, the EF, LVEF, FS and CO had no statistical differences in the cilazapril group as compared with the general treatment group. In the control group only LVEF and FS improved(P<0.01) ; Cytokine levels showed no changes. It suggests that cilazapril can reduce the serum levels of pro-inflammatory cytokines, increased the serum levels of anti-inflammatory cytokine, protect and improved cardiac function in the patients with congestive heart failure.

Key words: 
Heart failure,Congestive;  Cytokines;  Cilazapril
Plasma-based tumor mutational burden (bTMB) as predictor for survival in phase III EAGLE study: Durvalumab (D) ± tremelimumab (T) versus chemotherapy (CT) in recurrent/metastatic head and neck squamous cell carcinoma (R/M HNSCC) after platinum failure.
Authors: Weimin Li, Sophie Wildsmith, Jiabu Ye, Han Si, Nassim Morsli, Philip He, Jagdish Shetty, Alejandro Javier Yovine, Nicholas Holoweckyj, Rajiv Raja, Katia Real, Paul Scorer, Todd Hembrough, Jill Walker, Qu Zhang, Ricard Mesia, Robert I. Haddad, Lisa F. Licitra, Robert L. Ferris
Journal: Journal of Clinical Oncology (2020)

6511 Background: In NSCLC, bTMB assessed from circulating tumor DNA shows promise as a predictive survival biomarker for immunotherapy, but its value in R/M HNSCC is uncertain. We evaluated bTMB as a predictor of survival in R/M HNSCC. Methods: EAGLE (NCT02369874) was a randomized, open-label, phase 3 trial evaluating D (anti-PD-L1), or D+T (anti-CTLA-4), vs CT in R/M HNSCC. Patients (pts) with disease progression after platinum-based CT were randomized (1:1:1) to D (10 mg/kg intravenous [IV] every 2 weeks [Q2W]), D (20 mg/kg IV Q4W) + T (1 mg/kg IV Q4W for up to 4 doses, followed by D at 10 mg/kg Q2W) or CT. bTMB was assessed in pretreatment plasma samples using the Guardant Health OMNI platform. Association of somatic loss of function mutations with OS was assessed. Results: 736 intent-to-treat pts were randomized; 247 were evaluable for bTMB (BEP). bTMB expression was not linked to HPV status, PD-L1 status, age, gender, tumor location, or ECOG PS. Smoking and progression within 6 months on multi-modality CT in localized disease trended with higher bTMB. OS and PFS HRs were significantly improved for D or D+T vs CT in pts with high bTMB (≥16 mut/Mb) vs low (&lt;16 mut/Mb; Table). The benefit of D or D+T vs CT in pts with high bTMB generally improved with increasing cutoff. 74 pts (27 D, 20 D+T, 27 CT pts) were bTMB high. 18-month OS rates were higher for D+T (22%; 95% CI 7%–42%) and D (33%; 95% CI 17%–51%) vs CT (0%; 95% CI 0%–0%) in pts with high bTMB. Pts with mutations in KMT2D, a HNSCC tumor suppressor gene, showed improved OS for D+T vs CT (HR 0.39; 95% CI 0.18–0.85). A trend of improved OS for D+T vs CT (HR 0.19; 95% CI 0.03–1.03) was also seen in pts with ATM mutations. Conclusions: This is the first retrospective analysis of a phase 3 trial to show bTMB may be predictive of outcomes for checkpoint inhibitors in R/M HNSCC. In pts with high bTMB, D or D+T improved OS hazards by at least 60%, vs CT at cutoffs ≥16 mut/Mb. Validation of bTMB as a predictive biomarker is ongoing. Clinical trial information: NCT02369874 . [Table: see text]
Advances in clinical research on drug therapy for dementia
Authors: 李春波, 张明园, 吴文源
Journal: BMJ (2006)

痴呆是一种造成智力、人格和行为能力不断恶化且不可逆转的疾病.阿尔茨海默病(Alzheimer disease,AD)和血管性痴呆(vascular dementia,VD)是老年人中最常见的痴呆,但许多其他疾病亦可产生相似征象[1,2].随着老年人口比例的不断增高,痴呆患病率呈现上升趋势.目前65岁以上老人中痴呆患病率至少5%,而85岁以上则达30%[1]。
The contribution of clinical subtype to survival differences among patients with de novo and recurrent metastatic breast cancer (dMBC).
Authors: Danielle Marie File, Tomas Pascual, Allison Mary Deal, Amy Wheless, Elizabeth Claire Dees, Lisa A. Carey
Journal: Journal of Clinical Oncology (2020)

1030 Background: Patients with de novo metastatic breast cancer (dMBC) have superior median overall survival (mOS) compared to recurrent metastatic breast cancer (rMBC). Whether patient characteristics, prior treatment, tumor stage and innate biological differences contribute to this observation is unknown. Methods: Clinical and pathological data from patients diagnosed with MBC from 2011 to 2017 at the University of North Carolina (UNC) was obtained from the prospective UNC Metastatic Breast Cancer Clinical Database (223 dMBC, 607 rMBC). Only patients with known survival status were included. Subtype was determined by hormone receptor (HR) and HER2 staining of the primary tumor. Pathologic staging results were used when available, otherwise clinical staging was used. Patient and tumor characteristics were compared using chi-square testing, and survival outcomes by Cox proportional hazards modeling. Results: 26.9% of patients with MBC presented with dMBC, with significant variation in the ratio of dMBC to rMBC across subtypes. In particular, there were more cases of HER2+ dMBC than rMBC (26.9% vs 14.0%) and fewer cases of triple negative dMBC (20.6% vs 35.3%)(p-value &lt; 0.001). Nearly half of all cases of HR-/HER2+ MBC were de novo (48.2%). dMBC was significantly associated with older age (p = 0.002), lower grade (p = 0.027), higher T and N stage (p &lt; 0.001) and African American race (30% vs 22%, p = 0.022). There was no significant difference in proportion of patients with visceral metastatic disease or in number of metastatic sites at diagnosis. Median follow up was 39 months in both cohorts. mOS was 12 months greater in dMBC than rMBC (34m vs 22m, p &lt; 0.001). These differences were significant across all subtypes except HR+/HER2+. The difference in mOS between dMBC and rMBC was greatest in the HR-/HER2+ subgroup (45m vs 15m, p = 0.006). In multivariable analysis, dMBC remained associated with improved survival (adjusted hazard ratio 0.59, p &lt; 0.001) independent of variables including age, race, subtype, grade and number of metastatic sites at diagnosis. Conclusions: Patients with dMBC have significantly better prognosis than those with rMBC. This improved outcome is in part due to subtype variation, with more triple negative and fewer HER2+ tumors in rMBC, however these differences largely remained when stratified by subtype. In multivariable analysis, de novo presentation of MBC remained an independently significant contributor to longer survival. Further investigation should focus on biologic differences between dMBC and rMBC.
Brain metastasis in lung cancer: Are there any predictive risk factors?
Authors: Salma Ait Batahar
Journal: Journal of Clinical Oncology (2020)

e21740 Background: Lung cancer is the first cause of death by cancer worldwide. Brain metastases in lung cancer are associated to an even poorer prognosis of this cancer. Identifying patients with a higher risk of developing brain cancer may help their prognosis by including systematic brain radiotherapy to their treatment. But what are risk factors of brain metastasis occurrence in lung cancer patients? Methods: To answer this question, we conducted a case control study comparing two groups of lung cancer patients. The cases group included 35 lung cancer patients with brain metastasis at the moment of diagnosis while the control group was made of 49 lung cancer patient with no brain metastasis at the moment of diagnosis. Many parameters were compared between the two groups such as: professional exposure, type and duration of smoking, medical history, clinical and radiological presentation as well as the histological type of the carcinoma. Results: The mean age was 56 for the cases group and 61 for the control group. Nonsmokers represented 14% in the cases group and 4% in the control group. The average smoking was 34 pack-year for the cases group and 31 pack-year for the control group and in both groups 51% of patients smoked a mixture of tobacco and Cannabis. 36% of the control group patients had an exposure to a professional carcinogen while 48% of the cases group patients had one. Digital clubbing was found in 62% of cases group patients and in 51% of the control group patients. 17% of the cases group patients had two more metastases outside the lungs and other than the brain ones while this rate was only 6% for the control group patients. The mean level of LDH (Lactate Dehydrogenase) was 340 U/L for the cases group and 342 U/L for the control group while the CRP (C- reactive protein) one was 78 mg/L for the cases group and 59 mg/L for the control group. The main histological type found in both groups was Adenocarcinoma (25% in the cases group and 18% in the control group) followed by the poorly differentiated carcinoma in the cases group and the squamous cell carcinoma in the control group. Small cell carcinoma was found in 5% of the patients with brain metastases and in 8% of the patients without brain metastases. Conclusions: Patients with brain metastases have a higher professional carcinogens exposure, a higher percentage of nonsmokers, more digital clubbing, and higher CRP levels than patients with no brain metastases. They also have more than one metastasis at the moment of the diagnosis and the predominant histological types are Adenocarcinoma and poorly differentiated carcinoma.
Use of plasma androgen receptor (AR) testing to optimize docetaxel chemotherapy in castration-resistant prostate cancer (CRPC): A multicenter biomarker study.
Authors: Vincenza Conteduca, Elena Castro, Daniel Wetterskog, Emanuela Scarpi, Nuria Romero-Laorden, Giorgia Gurioli, Anuradha Jayaram, Cristian Lolli, Giuseppe Schepisi, Anna Wingate, Chiara Casadei, Rebeca Lozano, Nicole Brighi, Isabel Aragon, Mercedes Marín-Aguilera, Enrique González-Billalabeitia, Begona Mellado, David Olmos, Gerhardt Attard, Ugo De Giorgi
Journal: Journal of Clinical Oncology (2020)

5546 Background: Plasma AR status has been identified as a potential biomarker of response in CRPC patients receiving docetaxel or the AR-targeted therapies abiraterone or enzalutamide. However, the relevance of plasma AR in the overall management of CRPC patients (pts) receiving docetaxel at different dose due to the toxicity profiles and physician-patient preferences is unknown. Methods: This was a multi-institution study of associations between baseline plasma AR-copy-number status assessed by droplet digital PCR and outcome in 325 CRPC pts. Between September 2011 and July 2019 pts started treatment with docetaxel administered at standard regimen 75mg/m 2 every three weeks or adapted regimen (75-80% of standard recommended dose or 30mg/m 2 weekly administration) at the discretion of the treating physician. Patients were assigned randomly into 2 sets with a ratio 2:1 to either training (n=217) and internal validation (n=108) cohorts. Results: In our study, adapted regimen of docetaxel was administered in 68 (31.3%) and 35 (32.4%) of training and validation cohorts, respectively. Based on plasma AR status, 67 (30.9%) and 39 (36.1%) validation and training set pts were classified as AR gain, respectively. In men treated with standard docetaxel regimen, no difference in progression-free/overall survival (PFS/OS) was seen between plasma AR normal and gain in both cohorts. In patients treated with adapted docetaxel regimen, we observed a significantly shorter median PFS (3.9 vs. 6.4 months, HR 4.77, 95%CI 1.48-3.80, p=0.0003) and median OS (11.2 vs . 20.4 months, HR 2.87, 95%CI 1.73-2.13, p=0.0008) in the training cohort. This finding was confirmed in the validation cohort (median PFS: 4.8 vs. 7.4 months, HR 2.54, 95%CI 1.40-4.58, p=0.005, and median OS: 11.8 vs. 26.4 months, HR 5.00, 95%CI 2.59-9.65, p&lt;0.0001). In addition, AR-gained patients were less likely than AR normal to have a PSA decline when receiving an adapted regimen in both cohorts (p=0.010 e p=0.003, respectively). Conclusions: This study suggests that plasma AR may improve clinical decision making in choosing not only between AR-directed therapies and taxanes, but also between adapted and standard regimen of docetaxel in first- and subsequent-therapy lines, providing promising clinical implications to select the proper timing and dose of docetaxel. Prospective trials to validate these findings are warranted.
先天性多发性关节挛缩症的影像学表现
Authors: 唐小锋, 陈锋, 黄兴文, 梁鹏, 隋旭蕾, 冯佩佩
Journal: BMJ (2011)

先天性多发性关节挛缩症(AMC)是一种少见先天性疾病,以四肢关节挛缩畸形为特征,且出生时即呈现多关节挛缩[1-4],最常见为足内翻畸形,也伴其他多关节畸形或脊柱侧弯等.AMC病因不明,有神经性、感染性和宫内压迫等学说[5-6].2009年9月13日至26日我院举办的慈善义诊活动中收治了来自各地的AMC病例共16例,临床及影像资料完整,现分析如下。
慢性疼痛的用药问题(二)
Authors: 刘波涛, 樊碧发
Journal: BMJ (2012)

对于慢性疼痛的用药,在概括性原则下有很多细节需要注意.本文对临床常见镇痛药物如非甾体类消炎镇痛药(NSAIDs)、中枢性镇痛药、抗惊厥药等在应用时需注意的问题,做较详细的阐述,并着重介绍强阿片类药物在慢性疼痛中的使用。
韦格纳肉芽肿合并银屑病一例并文献复习
Authors: 王雁, 张奉春
Journal: BMJ (2006)

韦格纳肉芽肿(Wegener's granulomatosis, WG)是一种坏死性肉芽肿性血管炎,其病理改变以小血管壁的炎症为特征.银屑病是一种慢性复发性皮肤炎,两种疾病发病均与遗传和环境因素有关,但确切病因不明.WG合并银屑病国内外未见相关报告.北京协和医院收治1例,现报告如下,并初步探讨其发病机理。
Early plasma circulating tumor DNA (ctDNA) changes to predict response to first-line pembrolizumab +/- chemotherapy in non-small cell lung cancer (NSCLC).
Authors: Biagio Ricciuti, Christine Champagne, Greg Jones, Tadd Scott Lazarus, Anika E. Adeni, Michael L. Cheng, Geoffrey R. Oxnard, Mark M. Awad
Journal: Journal of Clinical Oncology (2020)

3518 Background: ctDNA shedding into plasma can be prognostic in lung cancer, and changes in plasma ctDNA levels correlate with response to systemic therapy. However, is unknown whether early detection of ctDNA levels change predicts response to first-line pembrolizumab +/- chemotherapy. We hypothesized that serial assessment of plasma ctDNA by next generation sequencing would enable early detection of response to immunotherapy in NSCLC prior to radiological assessment. Methods: Patients (pts) with advanced NSCLC who received first-line treatment with pembrolizumab +/- platinum doublet chemotherapy at the Dana-Farber Cancer Institute were enrolled in this study. Plasma collected from pts prior to starting therapy and serially after starting therapy was analyzed by NGS using enhanced tagged-amplicon sequencing (eTAm-Seq) of hotspots and coding regions from 36 genes (InVisionFirst-Lung). ctDNA allele fractions (AF) change was correlated with treatment responses. Results: Among 38 pts who received first-line pembrolizumab +/- platinum/pemetrexed, 9 (23.7%) had no ctDNA detected at baseline while 29 had alterations detected. Pembrolizumab was administered as monotherapy in 19 of the 29 pts (65.5%) and in combination with chemotherapy in 10 (34.5%). The median time to the first ctDNA assessment was 21 days (IQR:21-24). Pts who had a decrease in the max AF at the first blood drawn compared to pre-treatment AF had a significantly higher response rate to treatment with pembrolizumab +/- platinum doublet chemotherapy than those with an AF increase (64.5% vs 7.7%, P &lt; 0.01). The median PFS (mPFS) and median OS (mOS) were significantly longer among pts with early AF decrease compared to those with an AF increase mPFS: 13.7 vs 3.4 months, HR:0.20, P &lt; 0.01; mOS: 32.8 vs 14.7 months, HR:0.06, P &lt; 0.01). The median change in allele fraction at the first on-treatment blood draw was -90% (range: -100 to +65), -71% (range: -100 to +100) and +35% (range: +17 to +100) in pts with subsequent radiological response (N = 11), stable disease (N = 11) and progressive disease (N = 7), respectively (P &lt; 0.01). Among the 9 cases with no detected ctDNA at baseline, 2 pts with emergence of cfDNA within 8 weeks developed progressive disease. In the other 7 cases, ctDNA remained undetected. Conclusions: In pts with advanced NSCLC, rapid decreases in ctDNA prior to radiological assessment correlated with clinical benefit. These results suggest a potential role for ctDNA as an early pharmacodynamic biomarker of response or resistance to immunotherapies.