■关于晚期鳞状非小细胞肺癌(sq-NSCLC)中基线浆细胞游离DNA(cfDNA)的预后价值的数据有限。这项前瞻性观察性研究旨在评估局部晚期/转移性sq-NSCLC化疗后血浆cfDNA水平的变化及其与症状评分和放射学反应的相关性。
■IIIB/IIIC/IVsq-NSCLC化疗初治患者(n=59),患有慢性阻塞性肺疾病的吸烟者[COPD,纳入COPD对照(CC);n=27]和健康对照(n=25)。呼吸症状负担(RSB)和总症状负担(TSB)由呼吸困难的平均视觉模拟评分(VAS)计算,咳嗽,胸痛,咯血RSB,厌食症和疲劳(TSB所有六个)。从外周血中分离cfDNA。所有患者均接受铂双联化疗。在基线和化疗后进行RSB/TSB/cfDNA评估和对比增强计算机断层扫描(CECT)-胸部扫描。
■在基线时,13/59(22%)非小细胞肺癌,3/27(11%)CC和无(0%)健康对照具有可检测的cfDNA。所有三个CC都是重度吸烟者,没有恶性肿瘤的证据,并且在重复测试中无法检测到cfDNA水平。在sq-NSCLC组中,大多数是男性(95%),目前吸烟者(88%),重度吸烟者(70%)患有转移性疾病(59%),中位年龄为65岁。东方肿瘤协作组(ECOG)表现状态(PS)为0-1(56%)和2(42%)。RSB和TSB评分中位数分别为9[四分位距(IQR)=5-14]和16(IQR=9-23),分别。59名患者中,54人接受了≥1个周期,而27人接受了C4后评估,其中18/27(66.7%)的cfDNA水平可检测。无基线特征与cfDNA可检测性相关。中位总生存期(OS)和无进展生存期(PFS)分别为262天和167天,分别。ECOGPS≥2,RSB评分>9和TSB评分>16均与较差的OS和PFS相关,cfDNA可检测性也是如此[中位OS=97天vs.298天和中位数PFS=97天vs.197天;P=0.025;风险比(HR)=2.17]。
■在接受化疗的晚期sq-NSCLC患者中,基线cfDNA检测能力与不良OS和PFS独立相关。
UNASSIGNED: There is limited data on prognostic value of baseline plasma cell free DNA (cfDNA) in advanced squamous non-small cell lung cancer (sq-NSCLC). This prospective observational study aimed to assess change in plasma cfDNA levels in locally-advanced/metastatic sq-NSCLC with chemotherapy and its correlation with symptom-scores and radiological-responses.
UNASSIGNED: Chemotherapy-naive patients with stages-IIIB/IIIC/IV sq-NSCLC (n = 59), smokers with chronic obstructive pulmonary disease [COPD, COPD-controls (CC); n = 27] and healthy-controls (n = 25) were enrolled. Respiratory symptom burden (RSB) and total symptom burden (TSB) were calculated from mean visual-analog-scores (VAS) of dyspnoea, cough, chest pain, hemoptysis RSB, anorexia and fatigue (all six for TSB). cfDNA was isolated from peripheral blood. All patients received platinum-doublet chemotherapy. RSB/TSB/cfDNA assessment and contrast-enhanced computed tomography (CECT)-thorax scans were done at baseline and post-chemotherapy.
UNASSIGNED: At baseline, 13/59 (22%) sq-NSCLC, 3/27 (11%) CC and none (0%) healthy-controls had detectable cfDNA. All three CC were heavy smokers with no evidence of malignancy and undetectable cfDNA levels on repeat testing. In sq-NSCLC group, majority were males (95%), current-smokers (88%), heavy-smokers (70%), had metastatic disease (59%) with median age of 65 years. Eastern Co-operative Oncology Group (ECOG) performance status (PS) was 0-1 (56%) and 2 (42%). Median RSB- and TSB-scores were 9 [interquartile range (IQR) = 5-14] and 16 (IQR = 9-23), respectively. Of the 59 patients, 54 received ≥ 1 cycle while 27 underwent post-C4 evaluation with detectable cfDNA levels in 18/27 (66.7%). No baseline characteristic correlated with cfDNA detectability. Median overall survival (OS) and progression-free survival (PFS) were 262 days and 167 days, respectively. ECOG PS ≥ 2, RSB-score > 9 and TSB-score > 16 were all associated with worse OS and PFS as was cfDNA detectability [median OS = 97 days vs. 298 days and median PFS = 97 days vs. 197 days; P = 0.025; hazard ratio (HR) = 2.17].
UNASSIGNED: Baseline cfDNA detectability is independently associated with poor OS and PFS in patients with advanced sq-NSCLC on chemotherapy.