Prognostic value of circulating tumor DNA in operable non-small cell lung cancer: a systematic review and reconstructed individual patient-data based meta-analysis

作者全名："Chen, Dali; Guo, Jinbao; Huang, Hao; Tian, Lei; Xie, Yunbo; Wu, Qingchen"

作者地址："[Chen, Dali; Guo, Jinbao; Huang, Hao; Tian, Lei; Xie, Yunbo; Wu, Qingchen] Chongqing Med Univ, Dept Cardiothorac Surg, Affiliated Hosp 1, 1 Youyi Rd, Chongqing 400016, Peoples R China"

通信作者："Chen, DL; Wu, QC (通讯作者)，Chongqing Med Univ, Dept Cardiothorac Surg, Affiliated Hosp 1, 1 Youyi Rd, Chongqing 400016, Peoples R China."

来源：BMC MEDICINE

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001114091700001

JCR分区：Q1

影响因子：9.3

年份：2023

卷号：21

期号：1

开始页：　

结束页：　

文献类型：Article

关键词：Non-small cell lung cancer; Circulating tumor DNA; Disease-free survival; Meta-analysis; Individual patient data

摘要："BackgroundThis reconstructed individual patient data (IPD)-based meta-analysis is aimed to summarize the current findings and comprehensively investigate the predictive value of circulating tumor DNA (ctDNA) in operable non-small cell lung cancer (NSCLC).MethodsPubMed, Cochrane and Embase were searched to include potentially eligible studies. The primary outcomes included progression-free survival (DFS) by ctDNA status at baseline, postoperative, and longitudinal timepoints. The IPD-based survival data was retracted and used in reconstructed IPD-based meta-analysis. Subgroup analysis was implemented based on the baseline characteristics.ResultsTotally, 28 studies were involved, including 15 full-length articles (1686 patients) for IPD-based synthesis and 20 studies for conventional meta-analysis. The IPD-based meta-analysis discovered that patients with positive ctDNA status at the baseline (hazard ratio, HR = 3.73, 95% confidential interval, CI: 2.95-4.72), postoperative (3.96, 2.19-7.16), or longitudinal timepoints (12.33, 8.72-17.43) showed significantly higher risk of recurrence. Patients with persistent ctDNA-negative status had the lowest recurrence rate, and the negative conversion of ctDNA from baseline to postoperative timepoints was correlated with elevated DFS. Subgroup analyses suggested that stage II-III patients with ctDNA-positive status may achieve preferable therapeutic outcomes.ConclusionsPlasm ctDNA monitoring shows excellent clinical significance at the tested timepoints. Perioperative conversion of ctDNA status may indicate the therapeutic effect of radical surgery. Postoperative adjuvant therapy may be determined according to the ctDNA status.Trail registrationCRD42022304445."

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