Plasma cfDNA as a potential treatment monitoring and prognostic index in patients withnon-small cell lung cancer


Nan Chen, Gaofeng Li, Heng Li, Xudong Xiang, Gang Guo, Qianli Ma, Ying Zhang

Abstract


The purpose of this study was to investigate the potential of cell-free DNA (cfDNA) as a prognostic factor for non-small cell lung cancer (NSCLC).   Patients with NSCLC (n = 154) treated with gefitinib were recruited over a 5-year period for this study, and served as the observation group (79 males and 75 females, mean age = 53.74 ± 10.86 years). The control group (normal healthy individuals) consisted of 30 males and 22 females, aged 44 – 64 years (mean age = 54.12 ± 9.83 years). The follow-up lasted 5 years, or until the patient relapsed and died. The plasma level of cfDNA was determined in patients 1 day before treatment, 3 days after treatment, and on the 28th day of treatment.Based on the cfDNA expression level, NSCLC patients were subdivided into high-expression and low-expression groups, and differences in survival were compared. Univariate and multivariate analyses were performed on factors affecting patients survival using COX. Total effectiveness was significantly higher in observation group (49.35%) than in control group (13.95 %) (p<0.05). The extent of disease control wasalso significantly higher in the observation group (93.51 %) than in control group (p<0.05). Plasma cfDNA level of NSCLCpatients was significantly higher than that of control group before treatment, but was significantly and time-dependently reduced after gefitinib treatment (p<0.05). Cell-free DNA (cfDNA) level increased with severity of disease (p<0.05). Patients in cfDNA low-expression group had significantly higher chances of survival than those in the high-expression group (p<0.05). The results of Cox multivariate analysis showed that pathological severity and cfDNA concentration were independent factors affecting prognosis of NSCLC
(p<0.05). Plasma cfDNA is a potential prognostic index in patients with NSCLC.

Keywords


Cell-free DNA; Gefitinib; Lung cancer; Prognosis; Targeted therapy.

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