Circulating tumor DNA correlates with tumor burden and predicts outcome in pancreatic cancer irrespective of tumor stage.

Autor: Kirchweger P; Gastrointestinal Cancer Center, Linz, Austria; Department of Surgery, Ordensklinikum Linz, Austria; Johannes Kepler University Linz, Medical Faculty, Linz, Austria., Kupferthaler A; Department of Diagnostic and Interventional Radiology, Ordensklinikum Linz, Austria., Burghofer J; Laboratory for Molecular Genetic Diagnostics, Ordensklinikum Linz, Austria., Webersinke G; Laboratory for Molecular Genetic Diagnostics, Ordensklinikum Linz, Austria., Jukic E; Institute of Human Genetics, Medical University of Innsbruck, Austria., Schwendinger S; Institute of Human Genetics, Medical University of Innsbruck, Austria., Weitzendorfer M; Department of Surgery, Paracelsus Medical University Salzburg, Salzburg, Austria., Petzer A; Johannes Kepler University Linz, Medical Faculty, Linz, Austria; Department of Internal Medicine I for Hematology with Stem Cell Transplantaation, Hemostaseology and Medical Oncology, Ordensklinikum Linz, Austria., Függer R; Department of Surgery, Ordensklinikum Linz, Austria; Johannes Kepler University Linz, Medical Faculty, Linz, Austria., Rumpold H; Gastrointestinal Cancer Center, Linz, Austria; Johannes Kepler University Linz, Medical Faculty, Linz, Austria., Wundsam H; Department of Surgery, Ordensklinikum Linz, Austria. Electronic address: helwig.wundsam@ordensklinikum.at.
Jazyk: angličtina
Zdroj: European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology [Eur J Surg Oncol] 2022 May; Vol. 48 (5), pp. 1046-1053. Date of Electronic Publication: 2021 Dec 01.
DOI: 10.1016/j.ejso.2021.11.138
Abstrakt: Introduction: Circulating tumor DNA (ctDNA) represents a promising tool for diagnosis, prognosis and treatment monitoring of several malignancies. Its association with tumor burden in pancreatic ductal cancer (PDAC), especially in localized disease, is not fully explored yet. We aimed to investigate the association of pretherapeutic ctDNA levels in localized and metastatic PDAC with tumor volume and clinical outcomes.
Material and Methods: Liquid biopsy for ctDNA detection was prospectively obtained from patients with localized or disseminated PDAC prior to either resection or systemic treatment. Detection rates and levels of ctDNA (digital droplet PCR) were correlated to tumor volume, relapse rate and survival.
Results: 60 patients with localized and 47 patients with metastatic PDAC were included. ctDNA was detected in 10% of localized and 57.4% of metastasized PDAC samples. In localized disease, ctDNA detection significantly correlated with the numbers of involved locoregional lymph nodes (p = 0.030). Primary tumor volume did not correlate with ctDNA levels in neither localized (p = 0.573) nor metastasized disease (p = 0.878). In disseminated disease, ctDNA levels correlated with total tumor volume (p = 0.026) and especially with liver metastases volume (p = 0.004), but not with other metastases. Detection of pretherapeutic ctDNA was associated with shorter DFS in localized (3.3 vs. 18.1 months, p = 0.000), whereas ctDNA levels were associated with worse survival in metastatic PDAC (5.7 vs. 7.8 months, p = 0.036).
Conclusion: ctDNA positivity indicates major nodal involvement or even presence of undetected distant metastases associated with early recurrence in localized PDAC. Moreover, it predicts worse clinical outcome in both localized and metastatic disease.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2021 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.)
Databáze: MEDLINE
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