Molecular residual disease and efficacy of adjuvant chemotherapy in patients with colorectal cancer.
Molecular residual disease and efficacy of adjuvant chemotherapy in patients with colorectal cancer.
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DOI：
10.1038/s41591-022-02115-4
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发表时间：
2023-01
期刊：
影响因子：
82.9
通讯作者：
Yoshino, Takayuki
中科院分区：
文献类型：
--
作者：
Kotani, Daisuke;Oki, Eiji;Nakamura, Yoshiaki;Yukami, Hiroki;Mishima, Saori;Bando, Hideaki;Shirasu, Hiromichi;Yamazaki, Kentaro;Watanabe, Jun;Kotaka, Masahito;Hirata, Keiji;Akazawa, Naoya;Kataoka, Kozo;Sharma, Shruti;Aushev, Vasily N.;Aleshin, Alexey;Misumi, Toshihiro;Taniguchi, Hiroya;Takemasa, Ichiro;Kato, Takeshi;Mori, Masaki;Yoshino, Takayuki
尽管接受了标准治疗，但仍有超过30%的可切除结直肠癌（CRC）患者复发。循环肿瘤DNA（ctDNA）分析可能有助于术后风险分层和辅助化疗（ACT）治疗决策。我们报告来自GALAXY的结果，GALAXY是正在进行的CIRCULATE-日本研究（UMIN 000039205）的观察组，该研究分析了II-IV期可切除CRC患者（n = 1，039）的术前和术后ctDNA。在该队列中，中位随访时间为16.74个月（范围0.49-24.83个月），术后ctDNA阳性（术后4周）与较高的复发风险相关（风险比（HR）10.0，P < 0.0001），是与II期或III期CRC患者复发风险相关的最重要预后因素（HR 10.82，P < 0.001）。此外，术后ctDNA阳性确定了II期或III期CRC患者从ACT中获益（HR 6.59，P < 0.0001）。我们的研究结果是对可切除的CRC中ctDNA进行的一项大型和全面的前瞻性分析，支持使用ctDNA检测来识别复发风险增加并可能从ACT中获益的患者。在CIRCULATE-Japan研究的观察性GALAXY组中，在1，049例II-IV期结直肠癌患者中，肿瘤切除术后存在循环肿瘤DNA（ctDNA）的患者具有较高的复发风险，并且可能从辅助化疗中获益。
Despite standard-of-care treatment, more than 30% of patients with resectable colorectal cancer (CRC) relapse. Circulating tumor DNA (ctDNA) analysis may enable postsurgical risk stratification and adjuvant chemotherapy (ACT) treatment decision-making. We report results from GALAXY, which is an observational arm of the ongoing CIRCULATE-Japan study (UMIN000039205) that analyzed presurgical and postsurgical ctDNA in patients with stage II–IV resectable CRC (n = 1,039). In this cohort, with a median follow-up of 16.74 months (range 0.49–24.83 months), postsurgical ctDNA positivity (at 4 weeks after surgery) was associated with higher recurrence risk (hazard ratio (HR) 10.0, P < 0.0001) and was the most significant prognostic factor associated with recurrence risk in patients with stage II or III CRC (HR 10.82, P < 0.001). Furthermore, postsurgical ctDNA positivity identified patients with stage II or III CRC who derived benefit from ACT (HR 6.59, P < 0.0001). The results of our study, a large and comprehensive prospective analysis of ctDNA in resectable CRC, support the use of ctDNA testing to identify patients who are at increased risk of recurrence and are likely to benefit from ACT. In the observational GALAXY arm of the CIRCULATE-Japan study, among 1,049 patients with stage II–IV colorectal cancer, those with presence of circulating tumor DNA (ctDNA) after tumor resection have a high recurrence risk and are likely to benefit from adjuvant chemotherapy.
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影响因子：
4.6
作者：
Kasi PM;Fehringer G;Taniguchi H;Starling N;Nakamura Y;Kotani D;Powles T;Li BT;Pusztai L;Aushev VN;Kalashnikova E;Sharma S;Malhotra M;Demko ZP;Aleshin A;Rodriguez A;Billings PR;Grothey A;Taieb J;Cunningham D;Yoshino T;Kopetz S
通讯作者：
Kopetz S
DOI：
10.1056/nejmoa2200075
发表时间：
2022-06-16
期刊：
The New England journal of medicine
影响因子：
--
作者：
通讯作者：
--
影响因子：
6.6
作者：
Henriksen, Tenna V.;Reinert, Thomas;Andersen, Claus L.
通讯作者：
Andersen, Claus L.
影响因子：
8.4
作者：
Sobrero, Alberto F.;Puccini, Alberto;Bruzzi, Paolo
通讯作者：
Bruzzi, Paolo
影响因子：
28.4
作者：
Reinert, Thomas;Henriksen, Tenna Vesterman;Andersen, Claus Lindbjerg
通讯作者：
Andersen, Claus Lindbjerg