Circulating DNA and Survival in Solid Tumors.
- Ocaña A Translational Oncology Unit, Albacete University Hospital, Albacete, Spain. albertoo@sescam.jccm.es.
- Díez-González L Translational Oncology Unit, Albacete University Hospital, Albacete, Spain.
- García-Olmo DC Translational Oncology Unit, Albacete University Hospital, Albacete, Spain.
- Templeton AJ Department of Medical Oncology and Hematology, Kantonsspital St. Gallen, St. Gallen, Switzerland.
- Vera-Badillo F Divisions of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Department of Medicine, University of Toronto, Toronto, Canada.
- José Escribano M Translational Oncology Unit, Albacete University Hospital, Albacete, Spain.
- Serrano-Heras G Translational Oncology Unit, Albacete University Hospital, Albacete, Spain.
- Corrales-Sánchez V Translational Oncology Unit, Albacete University Hospital, Albacete, Spain.
- Seruga B Department of Medical Oncology, Institute of Oncology Ljubljana, Ljubljana, Slovenia.
- Andrés-Pretel F Translational Oncology Unit, Albacete University Hospital, Albacete, Spain.
- Pandiella A IBMCC-CSIC, Universidad de Salamanca, Salamanca, Spain.
- Amir E Divisions of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Department of Medicine, University of Toronto, Toronto, Canada.
- 2015-11-26
Published in:
- Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology. - 2016
English
BACKGROUND
The ability to undertake molecular analysis to inform on prognosis and predictors of response to therapy is limited by accessibility of tissue. Measurement of total circulating free DNA (cfDNA) or circulating tumor DNA (ctDNA) in peripheral blood may allow easier access to tumor material and help to predict clinical outcomes.
METHODS
A systematic review of electronic databases identified publications exploring the association between cfDNA or ctDNA and overall survival (OS) in solid tumors. HRs for OS were extracted from multivariable analyses and included in a meta-analysis. Pooled HRs were computed and weighted using generic inverse variance and random-effect modeling. For studies not reporting multivariable analyses, univariable ORs were estimated from Kaplan-Meier curves for OS at 1 and 3 years.
RESULTS
Thirty-nine studies comprising 4,052 patients were included in the analysis. Detection of ctDNA was associated with a significantly worse OS in multivariable analyses [HR, 2.70; 95% confidence interval (CI), 2.02-3.61; P < 0.001). Similar results were observed in the univariable analyses at 3 and 1 year (OR, 4.83; 95% CI, 3.20-7.28; P < 0.001).There was also a statistically significant association between high total cfDNA and worse OS for studies reporting multivariable and univariate data at 3 years (HR, 1.91; 95% CI, 1.59-2.29; P < 0.001 and OR, 2.82; 95% CI, 1.93-4.13; P < 0.001, respectively).
CONCLUSIONS
High levels of total cfDNA and presence of ctDNA are associated with worse survival in solid tumors.
IMPACT
Circulating DNA is associated with worse outcome in solid tumors.
The ability to undertake molecular analysis to inform on prognosis and predictors of response to therapy is limited by accessibility of tissue. Measurement of total circulating free DNA (cfDNA) or circulating tumor DNA (ctDNA) in peripheral blood may allow easier access to tumor material and help to predict clinical outcomes.
METHODS
A systematic review of electronic databases identified publications exploring the association between cfDNA or ctDNA and overall survival (OS) in solid tumors. HRs for OS were extracted from multivariable analyses and included in a meta-analysis. Pooled HRs were computed and weighted using generic inverse variance and random-effect modeling. For studies not reporting multivariable analyses, univariable ORs were estimated from Kaplan-Meier curves for OS at 1 and 3 years.
RESULTS
Thirty-nine studies comprising 4,052 patients were included in the analysis. Detection of ctDNA was associated with a significantly worse OS in multivariable analyses [HR, 2.70; 95% confidence interval (CI), 2.02-3.61; P < 0.001). Similar results were observed in the univariable analyses at 3 and 1 year (OR, 4.83; 95% CI, 3.20-7.28; P < 0.001).There was also a statistically significant association between high total cfDNA and worse OS for studies reporting multivariable and univariate data at 3 years (HR, 1.91; 95% CI, 1.59-2.29; P < 0.001 and OR, 2.82; 95% CI, 1.93-4.13; P < 0.001, respectively).
CONCLUSIONS
High levels of total cfDNA and presence of ctDNA are associated with worse survival in solid tumors.
IMPACT
Circulating DNA is associated with worse outcome in solid tumors.
- Language
-
- English
- Open access status
- bronze
- Identifiers
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- DOI 10.1158/1055-9965.EPI-15-0893
- PMID 26604269
- Persistent URL
- https://sonar.ch/global/documents/291121
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