ctDNA as an Adjunct to Posttreatment PET for Head and Neck Cancer Recurrence Risk Assessment.

Autor: Lele SJ; Department of Otolaryngology and Head Neck Surgery, Louisiana State University of Health Sciences, Shreveport, Louisiana, USA., Adilbay D; Department of Otolaryngology and Head Neck Surgery, Louisiana State University of Health Sciences, Shreveport, Louisiana, USA., Lewis E; Department of Otolaryngology and Head Neck Surgery, Louisiana State University of Health Sciences, Shreveport, Louisiana, USA.; Feist Weiller Cancer Center, Shreveport, Louisiana, USA., Pang J; Department of Otolaryngology and Head Neck Surgery, Louisiana State University of Health Sciences, Shreveport, Louisiana, USA.; Feist Weiller Cancer Center, Shreveport, Louisiana, USA., Asarkar AA; Department of Otolaryngology and Head Neck Surgery, Louisiana State University of Health Sciences, Shreveport, Louisiana, USA.; Feist Weiller Cancer Center, Shreveport, Louisiana, USA., Nathan CO; Department of Otolaryngology and Head Neck Surgery, Louisiana State University of Health Sciences, Shreveport, Louisiana, USA.; Feist Weiller Cancer Center, Shreveport, Louisiana, USA.
Jazyk: angličtina
Zdroj: Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery [Otolaryngol Head Neck Surg] 2024 Aug; Vol. 171 (2), pp. 439-444. Date of Electronic Publication: 2024 Apr 09.
DOI: 10.1002/ohn.760
Abstrakt: Objective: Circulating tumor DNA (ctDNA) detection is an emerging technique that identifies minimal residual disease in patients with solid tumors. ctDNA can act as an adjunct method to help overcome the limitations of positron emission tomography (PET) and select patients who are at high risk for recurrence.
Study Design: Retrospective Single Institutional Study.
Setting: University Hospital Setting.
Methods: Twenty-nine patients who underwent definitive treatment for squamous cell carcinoma of the head and neck (HNSCC) from 8/2021 to 01/2023 had ctDNA levels analyzed at 1 to 3, 6, 9, and 12 months after definitive treatment. A personalized, tumor-informed, multiplex polymerase chain reaction (PCR) next-generation sequencing (NGS) assay was used to detect the ctDNA levels. The primary outcome was recurrence-free probability (RFP), and the secondary outcomes were overall survival (OS), sensitivity, specificity, and the test's negative (NPV) and positive predictive values (PPV).
Results: The median age of patients was 65 years (interquartile range: 56-69), with majority being males (n = 22, 76%). The primary sites were larynx (n = 12), oropharynx (n = 10), and oral cavity (n = 6). Posttreatment ctDNA was detected in 7 patients, all of whom had disease recurrence. ctDNA detection after definitive treatment was associated with a higher risk of disease recurrence (hazard ratio: 9.94, 95% confidence interval: 1.56-63.3, P = .015). ctDNA identified recurrence with 100% specificity and 78% sensitivity. The NPV and PPV were 91% and 100%. PET had 78% sensitivity but only 68% specificity with 86% NPV, and 54% PPV.
Conclusion: Based on our data, ctDNA can be an excellent adjunct test for posttreatment PET and can help guide physicians in cases where PET results are inconclusive and difficult to interpret.
(© 2024 American Academy of Otolaryngology–Head and Neck Surgery Foundation.)
Databáze: MEDLINE
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