Prognostic value of ctDNA detection in patients with early breast cancer undergoing neoadjuvant therapy: A systematic review and meta-analysis

医学 荟萃分析 肿瘤科 内科学 乳腺癌 新辅助治疗 癌症
作者
Andri Papakonstantinou,Nadia Saoudi,Isabel Pimentel,Anna Suñol,Esther Zamora,Carolina Ortiz,Martín Espinosa-Bravo,Vicente Peg,Ana Vivancos,Cristina Saura,Guillermo Villacampa,Mafalda Oliveira
出处
期刊:Cancer Treatment Reviews [Elsevier BV]
卷期号:104: 102362-102362 被引量:64
标识
DOI:10.1016/j.ctrv.2022.102362
摘要

Circulating tumor DNA (ctDNA) is increasingly being used as a biomarker in early breast cancer (EBC). We performed a systematic review and meta-analysis to investigate the prognostic value of ctDNA in patients with EBC treated with neoadjuvant therapy (NAT). We searched Medline, Web of Science and Embase for observational or interventional studies that included patients with EBC undergoing NAT, reported outcomes related to the predefined endpoints, and had full text articles available. Study selection followed the PRISMA guidelines and quality assessment the REMARK tool for biomarker studies. Primary endpoint was impact of ctDNA detection in different time points (baseline, on-treatment, and after NAT) on relapse-free survival (RFS) and overall survival (OS). Secondary endpoints included the association of ctDNA detection with pathologic complete response (pCR), and the positive and negative predictive value of ctDNA detection in predicting residual disease after NAT. From the 2908 studies initially identified, 11 met the eligibility criteria and were included in the meta-analysis. Detection of ctDNA, both at baseline and after completion of NAT, significantly associated to worse RFS (HR 4.22, 95% CI: 1.29–13.82 and HR 5.67, 95% CI: 2.73–11.75, respectively) and worse OS (HR 19.1, 95% CI: 6.9–53.04 and HR 4.00, 95% CI: 1.90–8.42, respectively). In contrast, detection of ctDNA did not associate with the probability of achieving a pCR. Our results suggest that ctDNA assessment during NAT for EBC merits further evaluation as a stratification risk factor in prospective trials, in order to better individualize patient’s treatment.
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