Circulating free DNA concentration is an independent prognostic biomarker in lung cancer

Abstract

@ERSpublications Total cell-free DNA is not associated with chemotherapy response in advanced nonsmall cell lung cancer http://ow.ly/Qpqyx ABSTRACT Plasma circulating cell-free (cf)DNA is of interest in oncology because it has been shown to contain tumour DNA and may thus be used as liquid biopsy. In nonsmall cell lung cancer (NSCLC), cfDNA quantification has been proposed for the monitoring and follow-up of patients. However, available studies are limited and need to be confirmed by studies with larger sample sizes and including patients who receive more homogenous treatments. Our objective was to assess the predictive and prognostic value of plasma cfDNA concentration in a large series of patients with NSCLC and treated with a standard chemotherapy regimen.We included samples from lung cancer patients recruited into the Pharmacogenoscan study. The cfDNA of 218 patients was extracted and quantified by fluorometry before and after two or three cycles of platinum-based chemotherapy. The association between baseline and post-chemotherapy concentrations and treatment response, assessed by RECIST (response evaluation criteria in solid tumours) or patient survival was analysed.Patients with high cfDNA concentrations (highest tertile) at baseline had a significantly worse disease-free and overall survival than those with lower concentrations (lowest and middle tertiles) (median overall survival 10 months (95% CI 10.7-13.9) versus 14.2 months (95% CI 12.6-15.8), respectively; p=0.001). In multivariate analysis, increased baseline concentration of cfDNA was an independent prognostic factor. However, we did not find any association between cfDNA concentration and response to treatment.cfDNA may be a biomarker for the assessment of prognosis in NSCLC. However, total concentration of cfDNA does not appear to predict chemotherapy response.

Exploratory Analysis of TP53 Mutations in Circulating Tumour DNA as Biomarkers of Treatment Response for Patients with Relapsed High-Grade Serous Ovarian Carcinoma: A Retrospective Study

“…Three courses from three separate patients had missing PS, and PS was imputed as the mean PS value for all courses in the model. Total cell-free DNA level (TP53TAC) was included in the multivariable model because it has been reported as a possible independent prognostic marker in ovarian and other cancers [37,38]. …”

Circulating cell-free DNA as a prognostic and predictive biomarker in non-small cell lung cancer

“…A large number of studies had investigated the predictive or prognostic value of cfDNA concentration in NSCLC patients in recent years [19–22] (see Table 1 for references). However, these studies were often small and reported varying results.…”

Circulating DNA as a Strong Multimarker Prognostic Tool for Metastatic Colorectal Cancer Patient Management Care

“…In a recent large meta-analysis, a high correlation between ccfDNA concentration and mCRC patient survival was observed, revealing that patients with relatively low levels of ccfDNA lived significantly longer than patients with higher levels (6). The relevance of ccfDNA levels for the prognosis of other cancer types has also been described, including advanced breast cancer (10), lung cancer (11,12), prostate cancer (13), pancreatic cancer (14), and other cancer types (15).…”