Quantification of circulating cell-free DNA to predict patient survival in non-small-cell lung cancer
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Myung Han Hyun1,2,*, Jae Sook Sung2,*, Eun Joo Kang1, Yoon Ji Choi1, Kyong Hwa Park1, Sang Won Shin1, Sung Yong Lee3 and Yeul Hong Kim1,2
1Division of Medical Oncology, Department of Internal Medicine, Korea University Medical Center, Korea University College of Medicine, Seoul, Republic of Korea
2Cancer Research Institute, Korea University, Seoul, Republic of Korea
3Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Korea University Medical Center, Korea University College of Medicine, Seoul, Republic of Korea
*These authors have contributed equally to this work
Yeul Hong Kim, email: email@example.com
Keywords: cell-free DNA concentration, prognostic value, non-small-cell lung cancer
Received: July 05, 2017 Accepted: September 21, 2017 Published: October 10, 2017
We used computed tomography (CT) to explore the prognostic value of cell-free (cf) DNA quantification and its predictive efficacy over time after chemotherapy in non-small-cell lung cancer (NSCLC) patients. In total, 177 NSCLC patients were enrolled in a prospective biomarker trial. Consecutive paired blood collection was performed to determine cfDNA concentrations at baseline CT and throughout serial follow-ups. The best cfDNA cut-off value to predict progression-free and overall survival was determined using X-tile analysis. Among 112 chemo-naive patients with stage IV adenocarcinoma, 43 were available for follow-up analysis. Cox regression multivariate analysis indicated that a high cfDNA concentration was an independent negative prognostic factor for progression-free survival (hazard ratio: 2.60; 95% confidence interval: 1.65-4.10; p = 0.008) and overall survival (hazard ratio: 2.63; 95% confidence interval: 1.66-4.17; p < 0.001). However, cfDNA concentration changes during treatment did not correlate with radiological CT responses at first follow-up or best response. No pattern was noted in the percent change in the cfDNA concentration from baseline or subsequently measured level to progression. The serum cfDNA concentration is thus associated with NSCLC patient prognosis, but does not appear to be a clinically valid marker for tumor responses.
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