KEY TAKEAWAYS
- The study aimed to investigate the role of cfDNA and ctDNA monitoring in anticipating disease relapse in patients with EC.
- Researchers noticed that cfDNA and ctDNA monitoring improve risk stratification and relapse prediction in EC.
Carlos Casas-Arozamena and the team aimed to evaluate the effectiveness of cfDNA and ctDNA monitoring in enhancing the clinical management of patients with localized and recurrent endometrial cancer (EC).
Given the increasing incidence and mortality rates associated with EC, it is crucial to refine post-surgery recurrence risk stratification and predict disease relapse and treatment resistance. Liquid biopsy analyses present a promising solution to these clinical challenges, yet the optimal application strategies for these tools in EC remain to be established.
They performed an inclusive analysis of plasma samples and uterine aspirates (UA) from 198 patients with EC collected at surgery and during follow-up. The genetic landscape of the UA was characterized using targeted sequencing, and total cfDNA was analyzed for the presence of ctDNA based on the mutational profile identified in the UA.
About high cfDNA levels and detectable ctDNA at baseline correlated with poor prognosis for disease-free survival (DFS) (P-value < 0.0001; HR = 9.25) and disease-specific survival (DSS) (P-value < 0.0001; HR = 11.20).
This correlation remained clinically significant when stratifying tumors by histopathological risk factors. Notably, cfDNA/ctDNA analyses distinguished patients with early post-surgery relapse, and ctDNA kinetics identified patients experiencing relapse before any clinical evidence became apparent.
The study concluded that this is the most comprehensive analysis of cfDNA/ctDNA characterization in EC, highlighting its effectiveness in enhancing risk stratification and predicting disease relapse in patients with localized disease.
The assessment of ctDNA kinetics complements existing strategies for monitoring disease progression and treatment response. Consequently, the implementation of cfDNA/ctDNA monitoring in clinical practice presents a unique opportunity to advance the management of EC.
The study was funded by the Instituto de Salud Carlos III (ISCIII) (PI20/00969, PI21/00990 and PI20/01566)/Co-fund by the European Union for A.G-M, M.A and L.M-R; the Ministerio de Ciencia, Innovación y Universidades, Agencia Estatal de Investigación (PID2022-136854OB-I00) for G.M-B, the CIBERONC CB16/12/00328 for L.M-R, EC, A.G-M and MA) and CB16/12/00295 for G.M-B) and the Fundación científica AECC, Proyectos de Excelencia (IN607D2021/05) for L.M-R and ERA PerMed ERA-NET cofunded by the European Union, NextGeneration-EU through ISCIII and FCAECC (AC21_2/00020) for G.M-B and L.M-R. L.M-R and EC are supported by a contract “Miguel Servet” from ISCIII (CP20/00119, CP22/00147, respectively). SO is funded by an FCAECC-postdoctoral grant (PI21/00990). C.C-A is funded by an IDIS-predoctoral grant (2020). J.R-B is supported by a Juan Rodés contract (JR21/00019) from ISCIII.
Source: https://pubmed.ncbi.nlm.nih.gov/39304963/
Casas-Arozamena C, Vilar A, Cueva J, et al. (2024). “Role of cfDNA and ctDNA to improve the risk stratification and the disease follow-up in patients with endometrial cancer: towards the clinical application.” J Exp Clin Cancer Res. 2024;43(1):264. Published 2024 Sep 20. doi:10.1186/s13046-024-03158-w
