Author/Editor		Ocaña, Alberto; Díez-González, Laura; Garcia-Olmo, D. C.; Templeton, Arnoud J.; Vera-Badillo, Francisco Emilio; Gascón-Escribano, María J.; Serrano-Heras, G.; Corrales-Sánchez, Verónica; Šeruga, Boštjan; Andrés-Pretel, F.; Pandiella, Atanasio; Amir, Eitan
Title		Circulating DNA and survival in solid tumors
Type		članek
Vol. and No.		Letnik 25, št. 2
Publication year		2016
Volume		str. 399-406
ISSN		1538-7755 - Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
Language		eng
Abstract		The ability to undertake molecular analysis to inform on prognosis and predictors of response to therapy is limited by accessibility of tissue. Measurement of total circulating free DNA (cfDNA) or circulating tumor DNA (ctDNA) in peripheral blood may allow easier access to tumor material and help to predict clinical outcomes. METHODS: A systematic review of electronic databases identified publications exploring the association between cfDNA or ctDNA and overall survival (OS) in solid tumors. Hazard ratios (HR) for OS were extracted from multivariable analyses and included in a meta-analysis. Pooled hazard ratios were computed and weighted using generic inverse-variance and random-effect modeling. For studies not reporting multivariable analyses, univariable odds ratios (OR) were estimated from Kaplan-Meier curves for OS at one and three years. RESULTS: Thirty-nine studies comprising 4052 patients were included in the analysis. Detection of ctDNA was associated with a significantly worse OS in multivariable analyses (HR 2.70, 95% CI 2.02-3.61, p<0.001). Similar results were observed in the univariable analyses at 3 and one year (OR 4.83, 95% CI 3.20-7.28, p<0.001).There was also a statistically significant association between high total cfDNA and worse OS for studies reporting multivariable and univariate data at 3 years (HR 1.91, 95% CI 1.59-2.29, p<0.001; and OR 2.82, 95% CI 1.93-4.13, p<0.001, respectively). CONCLUSIONS: High levels of total cfDNA and presence of ctDNA are associated with worse survival in solid tumors. IMPACT: circulating DNA is associated with worse outcome in solid tumors.
Keywords		solidni tumorji DNA biološki označevalci klinične študije solid tumors biomarkers clinical trials circulating DNA