在复发性/转移性头癌中,个性化循环瘤DNA动力学会为免疫检查点阻塞提供生存和反应信息
Daniel A Ruiz-Torres1,2,3,4, Ross D Merkin1,3,5, Michael E Bryan1,4
1Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Boston, MA, USA.
NPJ precision oncology
|August 22, 2025
概括
在治疗期间循环的瘤DNA (ctDNA) 水平预测了接受免疫检查点阻塞 (ICB) 的复发性/转移性头平细胞癌 (R/ M HNSCC) 患者的更好的结果. 这种非侵入性生物标志物表明存活率和疾病控制率有所改善.
科学领域:
- 癌症学
- 分子诊断
- 癌症生物标志物
背景情况:
- 由于预测生物标志物有限,复发性/ 转移性头平细胞癌 (R/ M HNSCC) 具有重大临床挑战.
- 免疫检查点封锁 (ICB) 是一种治疗途径,但患者的选择和监测仍然至关重要.
- 循环瘤DNA (ctDNA) 分析是一种新兴的非侵入性实时疾病评估方法.
研究的目的:
- 评估序列ctDNA监测作为R/ M HNSCC患者接受ICB治疗的预测生物标志物的有用性.
- 确定ctDNA阴性和临床结果之间的关联,包括疾病控制,整体存活率 (OS) 和无进展存活率 (PFS).
主要方法:
- 对16名用ICB治疗的R/ M HNSCC患者的137个血样本进行分析.
- 使用基于瘤的,高度敏感的下一代测序试验 (RaDaR) 进行ctDNA检测.
- 在基线和整个治疗期间进行序列ctDNA监测.
- 使用单变量和多变量分析评估ctDNA水平与临床结果之间的关联.
主要成果:
- 治疗期间的ctDNA阴性与改善的疾病控制相关 (OR 21. 7, p=0. 0317).
- ctDNA阴性强烈预测了有利的三年整体存活率 (HR 0.04, p=0.0103) 和无进展的存活率 (HR 0.03, p=0.0057).
- 早期ctDNA水平的增加与随后的疾病进展相关.
结论:
- 在接受ICB治疗的R/ M HNSCC患者中,ctDNA阴性是一种强有力的非侵入性预测结果.
- 这种生物标志物的预测值独立于PD- L1表达,ICB疗法或治疗线.
- 序列ctDNA监测可以帮助实时评估治疗疗效和患者预后.
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