使用循环瘤DNA解读非转移性切除的头角状细胞癌中的分子复发和瘤内部异质性
Grégoire Marret1, Constance Lamy1, Sophie Vacher2
1Department of Drug Development and Innovation (D3i), Institut Curie, Paris-Saclay University, Paris, France.
Oral oncology
|November 29, 2024
概括
循环瘤DNA (ctDNA) 显示在检测瘤内异质性 (ITH) 和最小残留性疾病 (MRD) 中的头支状细胞癌 (HNSCC) 的承诺. 这种基于血液的生物标志物可以识别残留癌症,并比标准方法更早地预测复发.
科学领域:
- 在瘤学瘤学.
- 分子诊断学 分子诊断
- 遗传学 是一个遗传学.
背景情况:
- 头部和部状细胞癌 (HNSCC) 呈现出显著的瘤内异质性 (ITH),使基于单个活检的精确医学复杂化.
- 目前使用放射性成像进行的治疗反应评估未能检测到最小残留疾病 (MRD).
- 循环瘤DNA (ctDNA) 为ITH和MRD提供了潜在的非侵入性生物标志物.
研究的目的:
- 评估ctDNA作为ITH和MRD生物标志物的相关性,用于切除HNSCC.患者.
- 评估ctDNA检测在诊断和复发时的敏感性.
- 为了确定基于ctDNA的MRD检测是否可以预测临床复发.
主要方法:
- 对41名接受手术的非转移性切除性HNSCC患者进行前性研究.
- 向下一代瘤组织和连续血液样本的测序 (手术,术后,6个月,复发).
- 对ITH (缺失/新出现突变) 和MRD检测的ctDNA分析.
主要成果:
- 手术时ctDNA灵敏度为51%,复发时为68%.
- ctDNA分别在14%和43%的患者中发现了额外/新出现的突变,反映了ITH.
- 术后基于ctDNA的MRD检测预计复发的中位数为9.9个月 (63%的患者),与复发风险相关 (HR=3.0,p=0.03).
结论:
- ctDNA检测是评估HNSCC中ITH的一个有价值的生物标志物.
- 在可切除的HNSCC中,ctDNA作为MRD检测的敏感工具.
- 基于ctDNA的MRD监测可以预测疾病复发,有助于个性化治疗策略.
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