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评估头部和部状细胞癌的ctDNA导向辅助疗法降级:一个比较队列研究

Xu Zhang¹, Qigen Fang¹, Junhui Yuan²

¹Department of Head Neck and Thyroid, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, China.

Frontiers in immunology

|August 25, 2025

概括

术后循环瘤DNA (ctDNA) 测试在头平细胞癌 (HNSCC) 中确定了从化疗疗法中获益最多的患者,减少了41%,同时改善了局部控制.

科学领域:

癌症学
分子诊断
癌症生物标志物

背景情况:

循环瘤DNA (ctDNA) 是固体瘤中最小残留疾病的有希望的生物标志物.
对于指导脑皮细胞癌 (HNSCC) 的术后治疗选择,ctDNA的临床效用尚不清楚.
这项研究调查了ctDNA导向分层,以优化HNSCC患者在新辅助化疗后的局部控制.

研究的目的:

评估ctDNA引导分层在优化地方区域控制中的作用.
将ctDNA引导的治疗与HNSCC患者的传统治疗方案进行比较.
评估术后放射治疗和化疗 (PORT/POCRT) 使用率的影响.

主要方法:

对接受新辅助化疗免疫治疗的HNSCC患者进行比较的队列研究.
分为ctDNA指导和传统的管理组.
主要终点:三年地方区域控制;次要终点:POCRT使用率.

主要成果:

以ctDNA为指导的治疗显著降低了POCRT的利用率 (27.5%与42. 4%相比).
以ctDNA为指导的治疗显示出优异的局部控制,并降低了复发风险15%.
与传统治疗相比,在ctDNA指导的阳性患者中,POCRT的益处显著更大.

结论:

术后的ctDNA分析确定了最受益于POCRT的HNSCC患者.
以ctDNA为指导的管理使治疗利用率降低,同时保持卓越的局部区域控制.
在新辅助化学免疫治疗后,ctDNA 作为个性化管理的决定性生物标志物.

关键词:

在CtDNA中辅助性化疗头部和部状细胞癌新辅助化学免疫疗法病理完整反应

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