基于瘤的ctDNA深度测序检测到最小的残留疾病,并预测骨髓瘤复发
Yiwei Fu1,2, Yu Xu1,2, Weihai Liu1,2
1Department of Musculoskeletal Oncology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, China.
EClinicalMedicine
|July 18, 2024
概括
这项研究表明,在手术后检测循环瘤DNA (ctDNA) 可以比成像更早地预测骨髓瘤复发. 这种方法为监测最小残留疾病 (MRD) 和指导患者治疗提供了一个敏感的工具.
科学领域:
- 在瘤学瘤学.
- 基因组学就是基因组学.
- 生物标志物发现发现
背景情况:
- 目前的骨髓瘤复发监测方法缺乏敏感性和特异性.
- 循环瘤DNA (ctDNA) 显示出在固体瘤中检测最小残留疾病 (MRD) 的前景,但其在骨髓瘤中的应用需要进一步调查.
研究的目的:
- 评估瘤知情ctDNA分析的可行性和有效性,用于在骨髓瘤中纵向检测MRD.
- 评估ctDNA检测在预测骨髓瘤复发和结果中的预后价值.
主要方法:
- 整体外体序列 (WES) 用于为83名骨髓瘤患者开发个性化的ctDNA检测面板.
- 使用基于多重PCR的下一代测序 (NGS) 分析了纵向血液样本,以监测ctDNA水平.
- 使用卡普兰-梅尔曲线,Log-rank测试和考克斯回归分析,将ctDNA状态与无事件生存率 (EFS) 相对应.
主要成果:
- 在85.5%的患者中,成功生成了基于瘤的ctDNA面板.
- 在13名患者中观察到积极的手术后ctDNA检测,与ctDNA阴性患者相比,他们显示出明显更差的EFS.
- ctDNA检测作为EFS的独立预测指标,在5名患者中平均92.6天之前发现了阳性成像结果.
结论:
- 基于瘤的ctDNA深度测序适用于骨髓瘤MRD监测,是迄今为止最大的队列研究.
- 与标准成像相比,ctDNA检测是一个重要的预后因素,可以更早地识别瘤复发和进展.
- 这种方法为指导骨髓瘤患者管理和治疗策略提供了宝贵的见解.
相关概念视频
02:07Tumor Progression
Tumor progression is a phenomenon where the pre-formed tumor acquires successive mutations to become clinically more aggressive and malignant. In the 1950s, Foulds first described the stepwise progression of cancer cells through successive stages.
Colon cancer is one of the best-documented examples of tumor progression. Early mutation in the APC gene in colon cells causes a small growth on the colon wall called a polyp. With time, this polyp grows into a benign, pre-cancerous tumor. Further...
Colon cancer is one of the best-documented examples of tumor progression. Early mutation in the APC gene in colon cells causes a small growth on the colon wall called a polyp. With time, this polyp grows into a benign, pre-cancerous tumor. Further...
02:07Tumor Progression
Tumor progression is a phenomenon where the pre-formed tumor acquires successive mutations to become clinically more aggressive and malignant. In the 1950s, Foulds first described the stepwise progression of cancer cells through successive stages.
Colon cancer is one of the best-documented examples of tumor progression. Early mutation in the APC gene in colon cells causes a small growth on the colon wall called a polyp. With time, this polyp grows into a benign, pre-cancerous tumor. Further...
Colon cancer is one of the best-documented examples of tumor progression. Early mutation in the APC gene in colon cells causes a small growth on the colon wall called a polyp. With time, this polyp grows into a benign, pre-cancerous tumor. Further...