Ko Josephine Mun Yee, Ng Hoi Yan, Lam Ka On, Chiu Keith Wan Hang, Kwong Dora Lai Wan, Lo Anthony Wing Ip, Wong Jean Chrysei, Lin Roger Chia Wei, Fong Henry Chun Hung, Li Jason Ying Ki, Dai Wei, Law Simon, Lung Maria Li
Department of Clinical Oncology, University of Hong Kong, Hong Kong, China.
Department of Diagnostic Radiology, University of Hong Kong, Hong Kong, China.
Cancers (Basel). 2020 May 26;12(6):1352. doi: 10.3390/cancers12061352.
(1) Background: Early predictive markers to track treatment responses are needed for advanced esophageal squamous cell carcinoma (ESCC) patients. We examined the prognostication and risk stratification role of liquid biopsy serial monitoring for this deadly cancer. (2) Methods: Circulating tumor cells (CTCs) and plasma cell-free DNA (cfDNA) were isolated from 60 ESCC patients treated by chemotherapy (CT) at five serial timepoints: baseline (CTC1/cfDNA1), CT pre-cycle III (CTC2/cfDNA2), CT post-cycle IV, end of CT and relapse. (3) Results: In 45/57 ESCC patients with evaluable CTC counts at CT pre-cycle III, positive CTC2 (≥3 CTCs) is independently associated with response at interim reassessment and progression-free survival (PFS) in multivariate analysis. In 42/57 ESCC patients with changes of CTC1/CTC2 and cfDNA1/cfDNA2, patients categorized into four risk groups based on the number of favorable and unfavorable changes of CTC1/CTC2 and cfDNA1/cfDNA2, were independently associated with overall survival (OS) by multivariate analysis. (4) Conclusions: CTC counts at pre-cycle III are independently associated with response at interim reassessment and PFS. Combined changes of CTC counts and cfDNA levels from baseline to pre-cycle III are independently associated with OS. Longitudinal liquid biopsy serial monitoring provides complementary information for prediction and prognosis for CT responses in advanced ESCC.
（1）背景：晚期食管鳞状细胞癌（ESCC）患者需要早期预测标志物来追踪治疗反应。我们研究了液体活检连续监测在这种致命癌症中的预后和风险分层作用。（2）方法：从60例接受化疗（CT）的ESCC患者中，在五个连续时间点分离循环肿瘤细胞（CTC）和血浆游离DNA（cfDNA）：基线（CTC1/cfDNA1）、CT第三周期前（CTC2/cfDNA2）、CT第四周期后、CT结束时和复发时。（3）结果：在45/57例在CT第三周期前可评估CTC计数的ESCC患者中，多因素分析显示CTC2阳性（≥3个CTC）与中期重新评估时的反应和无进展生存期（PFS）独立相关。在42/57例CTC1/CTC2和cfDNA1/cfDNA2有变化的ESCC患者中，根据CTC1/CTC2和cfDNA1/cfDNA2有利和不利变化的数量分为四个风险组的患者，多因素分析显示与总生存期（OS）独立相关。（4）结论：第三周期前的CTC计数与中期重新评估时的反应和PFS独立相关。从基线到第三周期前CTC计数和cfDNA水平的联合变化与OS独立相关。纵向液体活检连续监测为晚期ESCC的CT反应预测和预后提供了补充信息。
