医学
免疫疗法
微卫星不稳定性
肿瘤科
液体活检
佐剂
免疫检查点
疾病
癌症
癌症研究
内科学
免疫系统
免疫学
微卫星
生物
等位基因
基因
生物化学
作者
Luc Cabel,Charlotte Proudhon,Emanuela Romano,Nicolas Girard,Olivier Lantz,Marc‐Henri Stern,Jean‐Yves Pierga,François‐Clément Bidard
标识
DOI:10.1038/s41571-018-0074-3
摘要
Considerable interest surrounds the use of immune-checkpoint inhibitors in patients with solid tumours following the demonstration of the impressive clinical efficacy of anti-programmed cell death protein 1 and anti-programmed cell death 1 ligand 1 antibodies in several tumour types. However, the emergence of unexpected tumour response patterns, such as pseudoprogression or hyperprogression, might complicate the management of patients receiving these agents. Analysis of circulating tumour DNA (ctDNA) has been shown to have prognostic value by enabling the detection of residual proliferating disease in the adjuvant setting and estimation of tumour burden in the metastatic setting, which are key stratification biomarkers for use of immune-checkpoint inhibition (ICI). Furthermore, examinations of ctDNA for genetic predictors of responsiveness to immunotherapy, such as mutations, tumour mutational load, and microsatellite instability provide a noninvasive surrogate for tumour biopsy sampling. Proof-of-concept reports have also demonstrated that quantitative changes in ctDNA levels early in the course of disease are a promising tool for the assessment of responsiveness to ICI that might complement standard imaging approaches. Other applications of this technology are also currently under investigation, such as early detection of resistance to immunotherapy and characterization of mechanisms of resistance. The aim of this Review is to summarize available data on the application of ctDNA in patients receiving immunotherapy and to discuss the most promising future directions.
科研通智能强力驱动
Strongly Powered by AbleSci AI