PMID- 35402598
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220413
IS  - 2305-5839 (Print)
IS  - 2305-5847 (Electronic)
IS  - 2305-5839 (Linking)
VI  - 10
IP  - 5
DP  - 2022 Mar
TI  - Monitoring early dynamic changes of plasma cell-free DNA and pretreatment 
      pre-albumin to predict chemotherapy effectiveness and survival outcomes in 
      advanced non-small cell lung cancer.
PG  - 253
LID - 10.21037/atm-22-12 [doi]
LID - 253
AB  - BACKGROUND: This study aimed to determine whether plasma cell-free DNA (cfDNA) 
      and pretreatment parameters provide useful therapeutic response and prognostic 
      information for advanced non-small cell lung cancer (NSCLC) patients. METHODS: A 
      total of 114 patients with advanced NSCLC who underwent systemic chemotherapy 
      were included in this study. Detection of plasma cfDNA concentration and blood 
      parameters before and at the sixth week after treatment was performed. The 
      prognostic value of cfDNA dynamic changes and laboratory parameters was 
      determined via a receiver operating characteristic (ROC) curve, and then analyzed 
      by comparing with the therapeutic efficacy and progression-free survival (PFS). 
      Based on the ROC curve, it revealed a pretreatment pre-albumin (PA) concentration 
      of 21.7 mg/dL was the cut-off value. The Cox proportional hazards regression 
      model was used to evaluate the predictive factors for treatment response and PFS 
      via univariate and multivariate analyses. RESULTS: Patients with cfDNA reduction 
      >/=20% at the sixth week after treatment reported a significantly better disease 
      control rate (DCR) and prolonged PFS (median PFS: 10.0 vs. 4.0 months, P<0.001). 
      The median PFS of low PA group (PA <21.7 mg/dL) was 6.0 months, while the median 
      PFS of high PA group (PA >/=21.7 mg/dL) was 8.0 months. The combined assessment of 
      cfDNA and pretreatment pre-albumin was associated with significantly better 
      survival outcomes compared with the remaining population (P<0.001). Multivariate 
      analysis for DCR indicated that cfDNA reduction >/=20% was an independent factor 
      (OR =0.419, P=0.001). In addition, multivariate analysis identified 6 significant 
      factors associated with PFS: cfDNA reduction of >/=20%, age <65 years, Eastern 
      Cooperative Oncology Group (ECOG) score >/=2, driver gene mutation, chemotherapy 
      combined regimen, and treatment response of complete response (CR) and partial 
      response (PR). The nomogram could predict the 2-year PFS probability of advanced 
      NSCLC patients after treatment, and the C-index was 0.817. CONCLUSIONS: 
      Monitoring cfDNA changes and pretreatment pre-albumin level in advanced NSCLC 
      patients receiving treatment is an accurate predictor of tumor response and PFS. 
      Combined assessment of cfDNA and pretreatment pre-albumin is helpful for 
      predicting survival outcomes. These findings may assist in identifying high-risk 
      patients and guiding treatment strategies.
CI  - 2022 Annals of Translational Medicine. All rights reserved.
FAU - Chen, Jia
AU  - Chen J
AD  - Department of Medical Oncology, The Affiliated Tumor Hospital of Nantong 
      University & Nantong Tumor Hospital, Nantong, China.
FAU - Shao, Jingjing
AU  - Shao J
AD  - Key Laboratory of Cancer Research Center of Nantong, The Affiliated Tumor 
      Hospital of Nantong University & Nantong Tumor Hospital, Nantong, China.
FAU - Zhang, Xunlei
AU  - Zhang X
AD  - Department of Medical Oncology, The Affiliated Tumor Hospital of Nantong 
      University & Nantong Tumor Hospital, Nantong, China.
FAU - Wei, Sheng
AU  - Wei S
AD  - Department of Radiation Oncology, The Affiliated Tumor Hospital of Nantong 
      University & Nantong Tumor Hospital, Nantong, China.
FAU - Cai, Hongyu
AU  - Cai H
AD  - Department of Hepatobiliary Surgery, The Affiliated Tumor Hospital of Nantong 
      University & Nantong Tumor Hospital, Nantong, China.
FAU - Wang, Gaoren
AU  - Wang G
AD  - Department of Radiation Oncology, The Affiliated Tumor Hospital of Nantong 
      University & Nantong Tumor Hospital, Nantong, China.
LA  - eng
PT  - Journal Article
PL  - China
TA  - Ann Transl Med
JT  - Annals of translational medicine
JID - 101617978
PMC - PMC8987881
OTO - NOTNLM
OT  - Advanced non-small cell lung cancer (advanced NSCLC)
OT  - chemotherapy efficacy
OT  - plasma cell-free DNA (plasma cfDNA)
OT  - therapeutic response
COIS- Conflicts of Interest: All authors have completed the ICMJE uniform disclosure 
      form (available at 
      https://atm.amegroups.com/article/view/10.21037/atm-22-12/coif). The authors have 
      no conflicts of interest to declare.
EDAT- 2022/04/12 06:00
MHDA- 2022/04/12 06:01
PMCR- 2022/03/01
CRDT- 2022/04/11 05:32
PHST- 2021/12/06 00:00 [received]
PHST- 2022/02/16 00:00 [accepted]
PHST- 2022/04/11 05:32 [entrez]
PHST- 2022/04/12 06:00 [pubmed]
PHST- 2022/04/12 06:01 [medline]
PHST- 2022/03/01 00:00 [pmc-release]
AID - atm-10-05-253 [pii]
AID - 10.21037/atm-22-12 [doi]
PST - ppublish
SO  - Ann Transl Med. 2022 Mar;10(5):253. doi: 10.21037/atm-22-12.