Feng S N, Cen X T, Tan R, Wei S S, Sun L D
Department of Dermatology, Zhujiang Hospital, Southern Medical University, No. 253 Gongye Avenue, Guangzhou, China.
Department of Dermatology, Zhujiang Hospital, Southern Medical University, No. 253 Gongye Avenue, Guangzhou, China; Departmet of Dermatology, the Fifth Affiliated Hospital of Southern Medical University, No.566 Congcheng Avenue, Guangzhou, China.
Transl Oncol. 2021 Jun;14(6):101072. doi: 10.1016/j.tranon.2021.101072. Epub 2021 Mar 18.
Circulating tumor DNA (ctDNA) has been investigated as a potential prognostic biomarker to evaluate the therapeutic efficacy and disease progression in melanoma patients, yet results remain inconclusive. The purpose of this study was to illustrate the prognostic value of ctDNA in melanoma.
To describe the clinical prognostic value of ctDNA for melanoma patients.
Searched for eligible articles from Pubmed, Web of Science and Embase. Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated to evaluate the association between ctDNA at baseline or during treatment and overall survival (OS) and progression-free survival (PFS).
A total of 9 articles were obtained, involving 617 melanoma patients. The pooled HRs revealed that compared with baseline undetectable ctDNA patients, detectable ctDNA was highly correlated with poor OS (HR 2.91, 95% CI: 2.22-3.82; p < 0.001) and PFS (HR 2.75, 95% CI: 1.98-3.83; p < 0.001). A meta-analysis of these adjusted HRs was performed and confirmed that ctDNA collected at baseline was associated with poorer OS/PFS (OS: HR 3.00, 95% CI 2.19-4.11, p < 0.001/PFS: HR 2.68, 95% CI 1.77-4.06, p < 0.001). During treatment, a significant association was shown between ctDNA and poorer OS/PFS (OS: HR 6.26, 95% CI 2.48-15.80, p < 0.001; PFS: HR 4.93, 95% CI 2.36-10.33, p < 0.001).
Investigation and application of ctDNA will improve "liquid biopsy" and play a role in early prediction, monitoring disease progression and precise adjusting treatment strategies in melanoma patients.
循环肿瘤DNA（ctDNA）已被作为一种潜在的预后生物标志物进行研究，以评估黑色素瘤患者的治疗效果和疾病进展，但结果仍无定论。本研究的目的是阐明ctDNA在黑色素瘤中的预后价值。
描述ctDNA对黑色素瘤患者的临床预后价值。
从PubMed、Web of Science和Embase中检索符合条件的文章。计算合并风险比（HRs）和95%置信区间（CIs），以评估基线或治疗期间ctDNA与总生存期（OS）和无进展生存期（PFS）之间的关联。
共获得9篇文章，涉及617例黑色素瘤患者。合并HRs显示，与基线ctDNA检测不到的患者相比，ctDNA可检测到与较差的OS（HR 2.91，95% CI：2.22-3.82；p < 0.001）和PFS（HR 2.75，95% CI：1.98-3.83；p < 0.001）高度相关。对这些调整后的HRs进行荟萃分析，证实基线时收集的ctDNA与较差的OS/PFS相关（OS：HR 3.00，95% CI 2.19-4.11，p < 0.001/PFS：HR 2.68，95% CI 1.77-4.06，p < 0.001）。在治疗期间，ctDNA与较差的OS/PFS之间存在显著关联（OS：HR 6.26，95% CI 2.48-15.80，p < 0.001；PFS：HR 4.93，95% CI 2.36-10.33，p < 0.001）。
ctDNA的研究和应用将改善“液体活检”，并在黑色素瘤患者的早期预测、监测疾病进展和精确调整治疗策略中发挥作用。
