Chia Brendan Seng Hup, Nei Wen Long, Charumathi Sabanayagam, Fong Kam Weng, Tan Min-Han
Division of Radiation Oncology, National Cancer Centre Singapore, Singapore, Singapore.
Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore.
Case Rep Oncol. 2020 Jul 29;13(2):896-903. doi: 10.1159/000508932. eCollection 2020 May-Aug.
The use of circulating cell-free tumour DNA (ctDNA) is established in metastatic lung adenocarcinoma to detect and monitor sensitising EGFR mutations. In early-stage disease, there is very little data supporting its role as a potential biomarker. We report on a prospective cohort of 9 limited-stage EGFR mutant lung cancer patients who were treated with radical radiotherapy. We looked at baseline plasma EGFR ctDNA and noted the detection rates to be higher in locally advanced disease. At a median follow-up of 13.5 months, an association between a detectable pre-radiotherapy plasma EGFR ctDNA and early tumour relapse (155 days vs. NR, = 0.004) was noted. One patient with persistent plasma EGFR ctDNA predated radiological progression. The role of ctDNA in early-stage lung cancer is developing. Plasma EGFR ctDNA could be a useful biomarker in lung cancer patients undergoing radical treatments for staging, prognostication, and follow-up. These preliminary findings should be explored in larger studies.
循环游离肿瘤DNA（ctDNA）已被用于转移性肺腺癌的检测和监测致敏性表皮生长因子受体（EGFR）突变。在早期疾病中，几乎没有数据支持其作为潜在生物标志物的作用。我们报告了一个前瞻性队列，其中9例局限性EGFR突变肺癌患者接受了根治性放疗。我们观察了基线血浆EGFR ctDNA，并注意到局部晚期疾病中的检测率更高。在中位随访13.5个月时，观察到放疗前血浆EGFR ctDNA可检测与早期肿瘤复发之间存在关联（155天对未达到，P = 0.004）。一名血浆EGFR ctDNA持续存在的患者先于影像学进展。ctDNA在早期肺癌中的作用正在发展。血浆EGFR ctDNA可能是接受根治性治疗的肺癌患者进行分期、预后评估和随访的有用生物标志物。这些初步发现应在更大规模的研究中进行探索。
