一线转移性结直肠癌中根据治疗强度的循环肿瘤DNA变异情况
ctDNA variations according to treatment intensity in first-line metastatic colorectal cancer.
作者信息
Grancher Adrien, Beaussire-Trouvay Ludivine, Vernon Virginie, Dutherage Marie, Blondin Valérie, Elie Caroline, Bouhier-Leporrier Karine, Galais Marie-Pierre, Clabaut Tifenn, Bignon Anne-Laure, Parzy Aurélie, Gangloff Alice, Schwarz Lilian, Lévêque Emilie, Sabourin Jean-Christophe, Michel Pierre, Vasseur Nasrin, Sefrioui David, Gilibert André, Di Fiore Frédéric
机构信息
Normandie Univ, UNIROUEN, Inserm U1245, IRON group, Normandy Centre for Genomic and Personalized Medicine and Department of Hepato-gastroenterology and Digestive Oncology, Rouen University Hospital, Rouen, France.
Normandie Univ, UNIROUEN, Inserm U1245, IRON group, Normandy Centre for Genomic and Personalized Medicine, Rouen University Hospital, Rouen, France.
出版信息
Br J Cancer. 2025 May;132(9):814-821. doi: 10.1038/s41416-025-02971-0. Epub 2025 Mar 15.
BACKGROUND
Circulating tumor DNA variations (∆ctDNA) were reported to be associated with treatment efficacy in metastatic colorectal cancer (mCRC). The present study evaluated ∆ctDNA according to first-line treatment intensity.
METHODS
Patients from two prospective ctDNA collections were divided into Group ≤ 2 drugs and Group ≥ 3 drugs. ∆ctDNA were analysed from baseline to cycle 3 or 4 (C) according to three predefined subgroups: ∆ctDNA ≥ 80%, ∆ctDNA ≥ 80%, and ∆ctDNA < 80%. Impact of ∆ctDNA on progression-free survival (PFS) and overall survival (OS) were analysed.
RESULTS
Pretreatment ctDNA was detected in 129/152 (84.9%) of patients. A ∆ctDNA ≥ 80% was more frequent in Group ≥ 3 than ≤ 2 drugs (respectively 51.5% vs. 32.7%, p = 0.015). Patients with ∆ctDNA ≥ 80% had longer survival than other ∆ctDNA subgroups, in Group ≥ 3 drugs (mPFS 11.5 vs 7.8 vs 6.3 months, p = 0.02: mOS 30.2 vs 18.1 vs 16.4 month, p = 0.04) and in Group ≤ 2 drugs (mPFS 8.4 vs 6.0 vs 5.3 months, p = 0.05; mOS 29.6 vs 14.6 vs 14.6 months, p = 0.007).
DISCUSSION
Early ∆ctDNA are associated to treatment intensity in first line mCRC with a significant impact on prognosis.
背景
循环肿瘤DNA变异（∆ctDNA）据报道与转移性结直肠癌（mCRC）的治疗疗效相关。本研究根据一线治疗强度评估∆ctDNA。
方法
来自两个前瞻性ctDNA收集队列的患者被分为≤2种药物组和≥3种药物组。根据三个预定义亚组，从基线到第3或第4周期（C）分析∆ctDNA：∆ctDNA≥80%、∆ctDNA≥80%和∆ctDNA<80%。分析∆ctDNA对无进展生存期（PFS）和总生存期（OS）的影响。
结果
129/152（84.9%）的患者检测到治疗前ctDNA。≥3种药物组中∆ctDNA≥80%的情况比≤2种药物组更常见（分别为51.5%对32.7%，p = 0.015）。在≥3种药物组（mPFS 11.5对7.8对6.3个月，p = 0.02；mOS 30.2对18.1对16.4个月，p = 0.04）和≤2种药物组（mPFS 8.4对6.0对5.3个月，p = 0.05；mOS 29.6对14.6对14.6个月，p = 0.007）中，∆ctDNA≥80%的患者生存期长于其他∆ctDNA亚组。
讨论
早期∆ctDNA与一线mCRC的治疗强度相关，对预后有显著影响。
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