دورية أكاديمية

The Prognostic Value of ctDNA and bTMB on Immune Checkpoint Inhibitors in Human Cancer

التفاصيل البيبلوغرافية
العنوان: The Prognostic Value of ctDNA and bTMB on Immune Checkpoint Inhibitors in Human Cancer
المؤلفون: Jiayan Wei, Jia Feng, Yiming Weng, Zexi Xu, Yao Jin, Peiwei Wang, Xue Cui, Peng Ruan, Ruijun Luo, Na Li, Min Peng
المصدر: Frontiers in Oncology, Vol 11 (2021)
بيانات النشر: Frontiers Media S.A., 2021.
سنة النشر: 2021
المجموعة: LCC:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
مصطلحات موضوعية: ctDNA, bTMB, immune checkpoint inhibitor, prognosis, biomarker, meta-analysis, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
الوصف: BackgroundCirculating tumor DNA (ctDNA) levels and blood tumor mutation burden (bTMB) have a significant impact on the prognosis of tumor patients. However, their prognostic role in immune checkpoint inhibitors (ICIs) in cancer patients is still unclear.MethodsWe used the Review Manager software (version 5.3) to perform a meta-analysis based on the published literature to explore the prognostic value of ctDNA and bTMB in patients receiving immunotherapy. We extracted the hazard ratios (HRs) of progression-free survival (PFS) and overall survival (OS) for each included study and their respective 95% confidence intervals (CIs) and p-values for analysis.ResultsThirteen studies were included in the meta-analysis. Higher ctDNA levels were significantly associated with shorter OS (HR = 3.35, 95%CI = 2.49–4.51, p < 0.00001) and PFS (HR = 3.28, 95%CI = 2.47–4.35, p < 0.00001). The results of ctDNA subgroup analysis showed that high posttreatment ctDNA levels significantly correlated with shorter OS in cancer patients receiving ICIs (HR = 5.09, 95%CI = 1.43–18.07, p = 0.01). Moreover, patients with ctDNA clearance had better OS (HR = 4.94, 95%CI = 2.96–8.26, p < 0.00001). Patients with high posttreatment ctDNA levels had shorter PFS (HR = 3.00, 95%CI = 2.02–4.46, p < 0.00001) and those with ctDNA clearance had longer PFS (HR = 4.61, 95%CI = 2.78–7.65, p < 0.00001). However, there was no statistically significant difference in the OS benefits between a high and a low bTMB after ICI therapy (HR = 0.68, 95%CI = 0.33–1.37, p = 0.28).ConclusionsThe host immune system and tumor burden together determine whether cancer patients can benefit from ICI therapy. Our systematic review and meta-analysis revealed for the first time that the levels of pretreatment and posttreatment ctDNA and the clearance of ctDNA can independently be used as prognostic factors for antitumor immunotherapy, while bTMB cannot. In conclusion, ctDNA levels have great potential as an assistant tool for radiological assessments to make clinical therapeutic decisions. The prognostic utility of bTMB still requires further exploration.
نوع الوثيقة: article
وصف الملف: electronic resource
اللغة: English
تدمد: 2234-943X
Relation: https://www.frontiersin.org/articles/10.3389/fonc.2021.706910/full; https://doaj.org/toc/2234-943X
DOI: 10.3389/fonc.2021.706910
URL الوصول: https://doaj.org/article/2e12603b64ee4d0c8007b0cceb2b7e7d
رقم الأكسشن: edsdoj.2e12603b64ee4d0c8007b0cceb2b7e7d
قاعدة البيانات: Directory of Open Access Journals
الوصف
تدمد:2234943X
DOI:10.3389/fonc.2021.706910