Department of Surgical Oncology and Gastrointestinal Surgery, Erasmus MC Cancer Institute, 3015 GD Rotterdam, The Netherlands.
Department of Medical Oncology, Erasmus MC Cancer Institute, 3015 GD Rotterdam, The Netherlands.
Cells. 2023 Oct 25;12(21):2520. doi: 10.3390/cells12212520.
Circulating tumour DNA (ctDNA) is a potential biomarker that could contribute to more judicious patient selection for personalised treatment. This review and meta-analysis gives an overview of the current knowledge in the literature investigating the value of ctDNA in patients with colorectal liver metastases (CRLM). A systematic search was conducted in electronic databases for studies published prior to the 26th of May 2023. Studies investigating the association between ctDNA and oncological outcomes in patients undergoing curative-intent local therapy for CRLM were included. Meta-analyses were performed to pool hazard ratios (HR) for the recurrence-free survival (RFS) and overall survival (OS). A total of eleven studies were included and nine were eligible for meta-analyses. Patients with detectable ctDNA after surgery experienced a significantly higher chance of recurrence (HR 3.12, 95% CI 2.27-4.28, < 0.000010) and shorter OS (HR 5.04, 95% CI 2.53-10.04, < 0.00001) compared to patients without detectable ctDNA. A similar association for recurrence was found in patients with detectable ctDNA after the completion of adjuvant therapy (HR 6.39, 95% CI 2.13-19.17, < 0.0009). The meta-analyses revealed no association between detectable ctDNA before surgery and the RFS and OS. These meta-analyses demonstrate the strong association between detectable ctDNA after treatment and oncological outcomes in CRLM patients.
循环肿瘤 DNA（ctDNA）是一种有潜力的生物标志物，可能有助于更明智地选择患者进行个体化治疗。这篇综述和荟萃分析概述了目前文献中关于 ctDNA 在结直肠癌肝转移（CRLM）患者中的价值的研究。在电子数据库中进行了系统搜索，以查找截至 2023 年 5 月 26 日之前发表的研究。纳入了研究 ctDNA 与接受根治性局部治疗的 CRLM 患者的肿瘤学结局之间关联的研究。进行荟萃分析以汇总无复发生存率（RFS）和总生存率（OS）的风险比（HR）。共纳入 11 项研究，其中 9 项符合荟萃分析条件。术后检测到 ctDNA 的患者复发的几率显著更高（HR 3.12，95%CI 2.27-4.28，<0.000010），OS 更短（HR 5.04，95%CI 2.53-10.04，<0.00001）与未检测到 ctDNA 的患者相比。在完成辅助治疗后检测到 ctDNA 的患者中也发现了类似的复发关联（HR 6.39，95%CI 2.13-19.17，<0.0009）。荟萃分析显示术前检测到 ctDNA 与 RFS 和 OS 之间无关联。这些荟萃分析表明，治疗后检测到的 ctDNA 与 CRLM 患者的肿瘤学结局之间存在很强的关联。
