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Br J Cancer:血浆ctDNA检测转移性黑色素瘤患者的临床进展分析

2021-08-16 xiaozeng MedSci原创

转移性黑色素瘤是最具侵袭性的一种皮肤癌类型,是大多数皮肤癌患者的主要死亡原因。

转移性黑色素瘤是最具侵袭性的一种皮肤癌类型,是大多数皮肤癌患者的主要死亡原因。在过去十年中,抗PD1(程序性细胞死亡蛋白1)和/或抗CTLA-4(细胞毒性T淋巴细胞相关抗原4)免疫疗法改变了晚期黑色素瘤患者的临床结局,这些治疗策略能够显著提高黑色素瘤患者的5年生存率。

包括18F-FDG-PET(18F标记的氟代脱氧葡萄糖正电子发射断层扫描)或CT(计算机断层扫描)在内的成像扫描技术目前是该疾病治疗和监测的临床标准。尽管如此,大部分患者仍会出现疾病的进展,即使在治疗中断后。因此,能够帮助临床医生准确检测患者进行性疾病的生物标志物至关重要。

ctDNA(循环肿瘤DNA)被逐渐的作为鉴定包括黑色素瘤在内的多种癌症状态的标志物。这种非侵入性的实时生物标志物已被证明可以准确的反映治疗前的肿瘤负荷,并提供预测或预后信息。然而,相比于医学成像,目前对于ctDNA临床有效性的研究尚不清楚。


在该研究中,研究人员收集了108个患者疾病进展时的血浆样本,并进行回顾性ctDNA分析。同时还在包括66名转移性黑色素瘤患者的验证队列中分析了患者对全身治疗反应后的前瞻性监测。

进展性黑色素瘤患者的ctDNA定量研究

结果显示,62%的患者在发生疾病进展时检测到ctDNA。对于67名对治疗有反应的患者,在疾病进展时的平均ctDNA水平显著高于治疗反应时。然而,通过泊松检验,这67名患者中只有30名(45%)患者的ctDNA具有统计学意义。


在前瞻性监测的验证队列中发现,患者疾病进展时ctDNA的检出率为56%,只有两个病例在放射学进展前显示出ctDNA的升高。最后,研究人员仅在未接受治疗的患者中观察到了ctDNA水平与代谢性肿瘤负荷之间的相关性,而在无BRAF抑制作用的亚组(N=15)中并未观察到的相关性。

血浆ctDNA水平与疾病临床进展的相关性

总而言之,该研究结果揭示,相比于标准的正电子发射断层扫描成像,ctDNA在检测黑色素瘤疾病进展方面的效率较低。


原始出处:

Marsavela, G., McEvoy, A.C., Pereira, M.R. et al. Detection of clinical progression through plasma ctDNA in metastatic melanoma patients: a comparison to radiological progression. Br J Cancer (09 August 2021).

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    2021-10-07 sunylz
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    2022-05-24 yyj072
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  5. 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  6. 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  7. 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    2021-08-17 1244c0ebm28暂无昵称

    学习

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  8. 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    2021-08-17 ms2000002024894779

    关注学习

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  9. 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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210313/9df56058b3964a8cac82563f95f0389d/c1b478592e8e4463bef44d32712e98fd.jpg, createdBy=ea905324251, createdName=SR~young海东, createdTime=Mon Aug 16 22:52:26 CST 2021, time=2021-08-16, status=1, ipAttribution=)]
    2021-08-17 ms8000001853030526

    0

  10. 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    2021-08-16 SR~young海东

    时刻关注学习

    0

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