Circulating Tumour DNA for Monitoring Treatment Response to Anti-PD-1 Immunotherapy in Melanoma Patients
Circulating Tumour DNA for Monitoring Treatment Response to Anti-PD-1 Immunotherapy in Melanoma Patients
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DOI：
10.2340/00015555-2748
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发表时间：
2017-11-01
影响因子：
3.6
通讯作者：
Okuyama, Ryuhei
中科院分区：
文献类型：
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作者：
Ashida, Atsuko;Sakaizawa, Kaori;Okuyama, Ryuhei
抗程序性细胞死亡-1(抗PD-1)抗体在晚期黑色素瘤患者中显示出高疗效。然而，由于肿瘤增大与肿瘤内炎症相关，对其治疗活性的评估可能具有挑战性。由于循环肿瘤DNA(CtDNA)与肿瘤负担相关，我们评估了ctDNA水平作为肿瘤变化指标的价值。5例BRAF或NRAS突变型黑色素瘤患者治疗过程中ctDNA(BRAF(突变型)或NRAS(突变型))的液滴数字聚合酶链式反应(Dropt Digital PCR)定量显示出与放射学和临床变化相对应的动态变化。在抗PD-1抗体有效的3例患者中，ctDNA水平在治疗开始后2-4周内下降。在2例抗PD-1抗体无效的病例中，治疗开始后ctDNA水平没有下降。CtDNA可作为预测抗PD-1免疫治疗的晚期黑色素瘤患者治疗早期反应的有用生物标志物。
Anti-programmed cell death-1 (anti-PD-1) antibody shows high therapeutic efficacy in patients with advanced melanoma. However, assessment of its therapeutic activity can be challenging because of tumour enlargement associated with intratumoural inflammation. Because circulating tumour DNA (ctDNA) correlates with tumour burden, we assessed the value of ctDNA levels as an indicator of tumour changes. Quantification of ctDNA (BRAF(mutant) or NRAS(mutant)) levels by droplet digital PCR in 5 patients with BRAF or NRAS mutant melanoma during the treatment course showed dynamic changes corresponding to radiological and clinical alterations. In 3 cases in which the anti-PD-1 antibody was effective, ctDNA levels decreased within 2-4 weeks after treatment initiation. In 2 cases in which the anti-PD-1 antibody was ineffective, ctDNA levels did not decrease after treatment initiation. ctDNA could be a useful biomarker to predict early response to treatment in patients with advanced melanoma treated with anti-PD-1 immunotherapy.