PDF(Pubmed)
Abstract：
BACKGROUND: Circulating tumor DNA (ctDNA) has emerged as a prognostic and predictive biomarker for detection of minimal residual disease (MRD), monitoring treatment response, and early detection of recurrence in cancer patients. In this study, we explored the utility of ctDNA-based MRD detection to predict recurrence in a real-world cohort of primarily early-stage non-small cell lung cancer (NSCLC) patients treated with curative intent.
METHODS: Longitudinal plasma samples were collected post curative-intent treatment from 36 patients with stage I-IV NSCLC. A personalized, tumor-informed assay was used to detect and quantify ctDNA in plasma samples.
RESULTS: Of the 24 patients with plasma samples available during the MRD window (within 6 months of curative surgery and before adjuvant therapy), ctDNA was detectable in two patients. Patients with ctDNA-positivity during the MRD window were 15 times more likely to recur compared to ctDNA-negative patients (HR: 15.0, 95% CI: 1.0-253.0, p = 0.010). At any time post-curative intent treatment, ctDNA-positivity was associated with significantly poorer recurrence-free survival compared to persistently ctDNA-negative patients (p < 0.0001).
CONCLUSIONS: Our real-world data indicate that longitudinal, personalized, tumor-informed ctDNA monitoring is a valuable tool in patients with NSCLC receiving curative treatment to identify patients at high risk for recurrence.
METHODS: Longitudinal plasma samples were collected post curative-intent treatment from 36 patients with stage I-IV NSCLC. A personalized, tumor-informed assay was used to detect and quantify ctDNA in plasma samples.
RESULTS: Of the 24 patients with plasma samples available during the MRD window (within 6 months of curative surgery and before adjuvant therapy), ctDNA was detectable in two patients. Patients with ctDNA-positivity during the MRD window were 15 times more likely to recur compared to ctDNA-negative patients (HR: 15.0, 95% CI: 1.0-253.0, p = 0.010). At any time post-curative intent treatment, ctDNA-positivity was associated with significantly poorer recurrence-free survival compared to persistently ctDNA-negative patients (p < 0.0001).
CONCLUSIONS: Our real-world data indicate that longitudinal, personalized, tumor-informed ctDNA monitoring is a valuable tool in patients with NSCLC receiving curative treatment to identify patients at high risk for recurrence.
摘要：
背景：循环肿瘤DNA（ctDNA）已成为检测微小残留病（MRD）的预后和预测性生物标志物，监测治疗反应，和癌症患者复发的早期检测。在这项研究中,我们探讨了基于ctDNA的MRD检测在预测接受治愈性治疗的早期非小细胞肺癌(NSCLC)患者的真实世界队列中复发的实用性.
方法：从36例I-IV期非小细胞肺癌患者治疗后收集纵向血浆样本。一个个性化的，肿瘤知情分析用于检测和定量血浆样品中的ctDNA.
结果：在MRD窗口期间（治愈性手术后6个月内和辅助治疗前）可获得血浆样本的24例患者中，在两名患者中检测到ctDNA。与ctDNA阴性患者相比，MRD窗口中ctDNA阳性患者复发的可能性是ctDNA阴性患者的15倍（HR：15.0，95％CI：1.0-253.0，p=0.010）。在治疗后的任何时间，与持续ctDNA阴性患者相比,ctDNA阳性与无复发生存率显著降低相关(p<0.0001)。
结论：我们的真实世界数据表明，纵向，个性化，在接受治愈性治疗的非小细胞肺癌患者中,肿瘤知情ctDNA监测是一种有价值的工具,可用于识别复发高危患者.
方法：从36例I-IV期非小细胞肺癌患者治疗后收集纵向血浆样本。一个个性化的，肿瘤知情分析用于检测和定量血浆样品中的ctDNA.
结果：在MRD窗口期间（治愈性手术后6个月内和辅助治疗前）可获得血浆样本的24例患者中，在两名患者中检测到ctDNA。与ctDNA阴性患者相比，MRD窗口中ctDNA阳性患者复发的可能性是ctDNA阴性患者的15倍（HR：15.0，95％CI：1.0-253.0，p=0.010）。在治疗后的任何时间，与持续ctDNA阴性患者相比,ctDNA阳性与无复发生存率显著降低相关(p<0.0001)。
结论：我们的真实世界数据表明，纵向，个性化，在接受治愈性治疗的非小细胞肺癌患者中,肿瘤知情ctDNA监测是一种有价值的工具,可用于识别复发高危患者.
