Association of circulating tumor DNA with patient prognosis in surgically resected renal cell carcinoma.

Autor:	Correa AF; Department of Urology, Fox Chase Cancer Center, Philadelphia, PA, United States., Kalashnikova E; Natera, Inc., Novato, CA, United States., Wu HT; Natera, Inc., Novato, CA, United States., Winters RM; Biosample Repository Facility, Fox Chase Cancer Center, Philadelphia, PA, United States.; WuXi Advanced Therapies, Cheltenham, PA, United States., Balcioglu M; Natera, Inc., Novato, CA, United States., Sudhaman S; Natera, Inc., Novato, CA, United States., Connolly DC; Biosample Repository Facility, Fox Chase Cancer Center, Philadelphia, PA, United States.; Nuclear Dynamics and Cancer, Fox Chase Cancer Center, Philadelphia, PA, United States., Gong Y; Department of Pathology, Fox Chase Cancer Center, Philadelphia, PA, United States., Uzzo RG; Department of Urology, Fox Chase Cancer Center, Philadelphia, PA, United States., Sethi H; Natera, Inc., Novato, CA, United States., ElNaggar AC; Natera, Inc., Novato, CA, United States., Aleshin A; Natera, Inc., Novato, CA, United States., Liu MC; Natera, Inc., Novato, CA, United States., Abbosh PH; Nuclear Dynamics and Cancer, Fox Chase Cancer Center, Philadelphia, PA, United States.; Department of Urology, Albert Einstein Medical Center, Philadelphia, PA, United States.
Jazyk:	angličtina
Zdroj:	The oncologist [Oncologist] 2024 Oct 03; Vol. 29 (10), pp. 887-893.
DOI:	10.1093/oncolo/oyae180
Abstrakt:	Background: Despite complete resection, 20%-50% of patients with localized renal cell carcinoma (RCC) experience recurrence within 5 years. Accurate assessment of prognosis in high-risk patients would aid in improving outcomes. Here we evaluate the use of circulating tumor DNA (ctDNA) in RCC using banked samples and clinical data from a single institution. Methods: The cohort consisted of 45 RCC patients (≥pT1b) who underwent complete resection. The presence of ctDNA in plasma was determined using a personalized, tumor-informed ctDNA assay (Signatera RUO, Natera, Inc.). Relationships with outcomes and other relevant clinical variables were assessed. The median follow-up was 62 months. Results: Plasma ctDNA was detected in 18 out of 36 patients (50%) pre-operatively and was associated with increased tumor size (mean 9.3 cm vs. 7.0 cm, P < .05) and high Fuhrman grade (60% grades III-IV vs 27% grade II, P = .07). The presence of ctDNA, either pre-operatively or at any time post-operatively, was associated with inferior relapse-free survival (HR = 2.70, P = .046; HR = 3.23, P = .003, respectively). Among patients who were ctDNA positive at any time point, the sensitivity of relapse prediction was 84% with a PPV of 90%. Of note, ctDNA positivity at a post-surgical time point revealed a PPV of 100% and NPV of 64%. The lack of ctDNA detection at both time points yielded an NPV of 80%. Conclusions: Detection of plasma ctDNA using a personalized assay is prognostic of recurrence in patients with resected RCC. Herein, we describe a successful approach for its application and identify potential limitations to be addressed in future studies. (© The Author(s) 2024. Published by Oxford University Press.)
Databáze:	MEDLINE
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