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Cancer Research and Treatment > Accepted Articles
doi: https://doi.org/10.4143/crt.2022.1557    [Accepted]
Early Plasma Circulating Tumor DNA as a Potential Biomarker of Disease Recurrence in Non-Metastatic prostate Cancer
Xiaochen Fei , Xinxing Du, Yiming Gong, Jiazhou Liu, Liancheng Fan, Jiayi Wang, Yanqing Wang, Yinjie Zhu, Jiahua Pan, Baijun Dong , Wei Xue
Department of Urology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
Correspondence  Baijun Dong ,Tel: 86-21-68383757, Email: dongbaijun@renji.com
Wei Xue ,Tel: 86-21-68383757, Email: xuewei@renji.com
Received: November 28, 2022;  Accepted: February 27, 2023.  Published online: March 2, 2023.
*Xiaochen Fei, Xinxing Du and Yiming Gong contributed equally to this work.
In non-metastatic prostate cancer (nmPCa) setting, it is important to early identify the patients at risk of biochemical recurrence (BCR) for immediate postoperative intervention. Our study aimed to evaluate the potential clinical utility of circulating tumor DNA (ctDNA) for predicting disease recurrence.
Materials and Methods
This real-world observational study evaluated 161 cases of nmPCa undergoing next-generation sequencing at our institution. A total of 139 ctDNA samples and 31 biopsied tumor tissue underwent genomic profiling. The study endpoint was BCR after radical prostatectomy. Relationships between the ctDNA status and the biochemical progression-free survival (bPFS) were analyzed by log-rank test and multivariate Cox regression.
Of 161 enrolled patients, 19(11.8%) harbored deleterious alterations in NCOR2, followed by BRCA2(3.7%), ATR(2.5%) and CDK12(2.5%). Of available pre-operative blood samples(n=139), ctDNA was detectable in 91(65.5%). Until last follow-up, 56 of 68(85.3%) patients with detectable ctDNA had achieved BCR, whereas only 8 of 39(20.5%) patients with undetectable ctDNA had achieved BCR. Patients who had undetectable ctDNA experienced significantly longer bPFS compared with those who had detectable ctDNA (NA vs. 8.2 mo, hazard ratio[HR]: 0.14, p<0.01). Pre-operative ctDNA status was a significant prognostic factor of disease recurrence.
Pre-operative ctDNA detection could identify patients at high risk of recurrence and has the potential to inform immediate postoperative interventions, but these approaches remain to be validated in prospective studies. ctDNA studies can provide insights into accurate monitoring and precise treatment rather than simply following routine clinical care.
Key words: Circulating Tumor DNA, Prostatic Neoplasms, Biomarkers
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