Circulating DNA and Survival in Solid Tumors
Circulating DNA and Survival in Solid Tumors
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DOI：
10.1158/1055-9965.epi-15-0893
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发表时间：
2016-02-01
影响因子：
3.8
通讯作者：
Amir, Eitan
中科院分区：
文献类型：
--
作者：
Ocana, Alberto;Diez-Gonzalez, Laura;Amir, Eitan
工作背景：进行分子分析以告知预后和对治疗的反应的预测因子的能力受到组织可及性的限制。测量外周血中的总循环游离DNA（cfDNA）或循环肿瘤DNA（ctDNA）可以更容易地获得肿瘤材料，并有助于预测临床outcome.Methods：电子数据库的系统性综述确定了探索实体瘤cfDNA或ctDNA与总生存期（OS）之间的关联的出版物。从多变量分析中提取OS的HR，并纳入荟萃分析。使用通用逆方差和随机效应模型计算合并HR并加权。对于未报告多变量分析的研究，根据Kaplan-Meier曲线估计OS在1和1时的单变量OR。结果：39项研究包括4，052例患者纳入分析。在多变量分析中，ctDNA的检测与OS显著更差相关[HR，2.70; 95%置信区间（CI），2.02-3.61; P < 0.001）。在3年和1年的单变量分析中观察到类似的结果（OR，4.83; 95%CI，3.20-7.28; P < 0.001）。对于报告3年时多变量和单变量数据的研究，高总cfDNA与较差OS之间也存在统计学显著相关性（HR，1.91; 95%CI，1.59-2.29; P < 0.001和OR，2.82; 95%CI，1.93-4.13; P < 0.001）。高水平的总cfDNA和ctDNA的存在与实体瘤的生存率降低相关。影响：循环DNA与实体瘤的预后降低相关。(C)2015年AACR。
Background: The ability to undertake molecular analysis to inform on prognosis and predictors of response to therapy is limited by accessibility of tissue. Measurement of total circulating free DNA (cfDNA) or circulating tumor DNA (ctDNA) in peripheral blood may allow easier access to tumor material and help to predict clinical outcomes.Methods: A systematic review of electronic databases identified publications exploring the association between cfDNA or ctDNA and overall survival (OS) in solid tumors. HRs for OS were extracted from multivariable analyses and included in a meta-analysis. Pooled HRs were computed and weighted using generic inverse variance and random-effect modeling. For studies not reporting multivariable analyses, univariable ORs were estimated from Kaplan-Meier curves for OS at 1 andResults: Thirty-nine studies comprising 4,052 patients were included in the analysis. Detection of ctDNA was associated with a significantly worse OS in multivariable analyses [HR, 2.70; 95% confidence interval (CI), 2.02-3.61; P < 0.001). Similar results were observed in the univariable analyses at 3 and 1 year (OR, 4.83; 95% CI, 3.20-7.28; P < 0.001). There was also a statistically significant association between high total cfDNA and worse OS for studies reporting multivariable and univariate data at 3 years (HR, 1.91; 95% CI, 1.59-2.29; P < 0.001 and OR, 2.82; 95% CI, 1.93-4.13; P < 0.001, respectively).Conclusions: High levels of total cfDNA and presence of ctDNA are associated with worse survival in solid tumors.Impact: Circulating DNA is associated with worse outcome in solid tumors. (C) 2015 AACR.