Assessment of circulating tumor DNA in patients with locally advanced rectal cancer treated with neoadjuvant therapy.

Autor: Molinari C; Biosciences Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) 'Dino Amadori', Via Piero Maroncelli, 40, Meldola (FC), 47014, Italy., Marisi G; Biosciences Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) 'Dino Amadori', Via Piero Maroncelli, 40, Meldola (FC), 47014, Italy. giorgia.marisi@irst.emr.it., Laliotis G; Natera, Inc., Austin, TX, USA., Spickard E; Natera, Inc., Austin, TX, USA., Rapposelli IG; Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) 'Dino Amadori', Meldola, Italy., Petracci E; Unit of Biostatistics and Clinical Trials, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) 'Dino Amadori', Meldola, Italy., George GV; Natera, Inc., Austin, TX, USA., Dutta P; Natera, Inc., Austin, TX, USA., Sharma S; Natera, Inc., Austin, TX, USA., Malhotra M; Natera, Inc., Austin, TX, USA., Prochowski Iamurri A; Radiology Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) 'Dino Amadori', Meldola, Italy., Feliciani G; Medical Physics Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) 'Dino Amadori', Meldola, Italy., Liu MC; Natera, Inc., Austin, TX, USA., Ulivi P; Biosciences Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) 'Dino Amadori', Via Piero Maroncelli, 40, Meldola (FC), 47014, Italy., Canale M; Biosciences Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) 'Dino Amadori', Via Piero Maroncelli, 40, Meldola (FC), 47014, Italy., Saragoni L; Operative Unit of Pathologic Anatomy, AUSL della Romagna, 'S. Maria delle Croci' Hospital, Ravenna, Italy., Gallo G; Department of Pathology, Bufalini Hospital, Cesena, Italy., Frassineti GL; Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) 'Dino Amadori', Meldola, Italy., Muratore M; Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) 'Dino Amadori', Meldola, Italy., Romeo A; Radiotherapy Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) 'Dino Amadori', Meldola, Italy., Jurdi A; Natera, Inc., Austin, TX, USA., Martinelli G; Department of Hematology and Sciences Oncology, Institute of Haematology 'L. and A. Seràgnoli', S. Orsola University Hospital, Bologna, Italy., Passardi A; Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) 'Dino Amadori', Meldola, Italy.
Jazyk: angličtina
Zdroj: Scientific reports [Sci Rep] 2024 Nov 28; Vol. 14 (1), pp. 29536. Date of Electronic Publication: 2024 Nov 28.
DOI: 10.1038/s41598-024-80855-8
Abstrakt: Post-neoadjuvant therapy (post-NAT) and post-surgical circulating tumor DNA (ctDNA) risk stratification may enhance the management of patients with locally advanced rectal cancer (LARC). In this study, we assessed the prognostic value of ctDNA-based MRD detection in LARC patients using a personalized, tumor-informed ctDNA assay. Plasma samples from LARC patients (N = 30) were analyzed retrospectively using the Signatera™ assay. The neoadjuvant rectal (NAR) score was calculated and compared to ctDNA status to predict recurrence risk and survival outcomes. ctDNA-positive patients post-NAT and post-surgery had worse Disease Free Survival (DFS) (HR: 7.82; p = 0.001, HR: 19.65; p = 0.001) when compared to ctDNA-negative patients. In the post-NAT setting, patients who responded to NAT had superior DFS compared to patients who did not clear their ctDNA or showed no radiological response (HR: 24.7, p = 0.001 and HR: 5.1, p = 0.054, respectively). When ctDNA status is used alongside the NAR score in the post-NAT setting, patients who were ctDNA-positive with an intermediate or high NAR score showed significantly worse DFS (HR: 47.5, p < 0.001) compared to ctDNA-negative patients with either a low or intermediate/high NAR score (HR: 9.8, p = 0.0301). Post-NAT ctDNA status, whether used alone or in combination with the NAR score, may predict NAT response, and improve risk stratification.
Competing Interests: Declarations. Competing interests: The authors declare no competing interests.
(© 2024. The Author(s).)
Databáze: MEDLINE
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