Longitudinal monitoring of circulating tumor DNA in plasma in patients with stage I-IIIA non-small cell lung cancer with EGFR mutations who were cured by surgery<\/h4><\/div><\/div><\/div><\/div><\/div><\/div><\/div>![](\"https:\/\/www.funcbio.cn\/wp-content\/uploads\/2023\/11\/\u80ba\u764cDNA\u7eb5\u5411\u76d1\u6d4b.png\" "\\"\u80ba\u764cDNA\u7eb5\u5411\u76d1\u6d4b\\"")
<\/span><\/div>INTRODUCTION \u4ecb\u7ecd<\/span><\/div><\/h4><\/div>For patients with early-stage epidermal growth factor receptor mutation positive (EGFR-M+) non-small cell lung cancer (NSCLC), curative surgery followed by adjuvant chemotherapy is considered the standard of care. This study assessed the feasibility and efficacy of longitudinal monitoring of circulating tumor DNA (ctDNA) as a valuable biomarker for early detection of minimal residual disease (MRD) and provides identification of the group at high-risk for recurrence in resected stage I-IIIA EGFR-M+ NSCLC.<\/p>\n
\u5bf9\u4e8e\u65e9\u671f\u8868\u76ae\u751f\u957f\u56e0\u5b50\u53d7\u4f53\u7a81\u53d8\u9633\u6027\uff08EGFR-M+\uff09\u975e\u5c0f\u7ec6\u80de\u80ba\u764c\uff08NSCLC\uff09\u60a3\u8005\uff0c\u6839\u6cbb\u6027\u624b\u672f\u540e\u8f85\u52a9\u5316\u7597\u88ab\u8ba4\u4e3a\u662f\u6807\u51c6\u6cbb\u7597\u65b9\u6cd5\u3002\u672c\u7814\u7a76\u8bc4\u4f30\u4e86\u5faa\u73af\u80bf\u7624DNA\uff08ctDNA\uff09\u7eb5\u5411\u76d1\u6d4b\u4f5c\u4e3a\u65e9\u671f\u5fae\u5c0f\u6b8b\u7559\u75c5\u7076\uff08MRD\uff09\u7684\u6709\u4ef7\u503c\u751f\u7269\u6807\u5fd7\u7269\u7684\u53ef\u884c\u6027\u548c\u7597\u6548\uff0c\u5e76\u786e\u5b9a\u4e86EGFR-M+ NSCLC\u624b\u672f\u5207\u9664\u7684I-IIIA\u671f\u60a3\u8005\u4e2d\u5177\u6709\u9ad8\u590d\u53d1\u98ce\u9669\u7684\u4eba\u7fa4\u3002<\/p>\n<\/div><\/div><\/div><\/div><\/div>
METHODS \u65b9\u6cd5<\/div><\/h4><\/div>Between August 2015 and October 2017, a total of 278 patients with curative resected, stage I-IIIA (AJCC 7 version) common EGFR-M+ NSCLC were analyzed. Radiological follow-up was accompanied with longitudinal monitoring of ctDNA using a droplet digital PCR from baseline (pre-operative), 4 weeks after curative surgery, and follow-up per protocol until 5 years. The primary outcomes were disease-free survival (DFS) according to the status of ctDNA positivity at landmark points and the sensitivity of longitudinal monitoring of ctDNA.<\/p>\n
\u5206\u6790\u4e862015\u5e748\u6708\u81f32017\u5e7410\u6708\u95f4\u5171278\u540d\u63a5\u53d7\u6839\u6cbb\u6027\u624b\u672f\u5207\u9664\u7684I-IIIA\u671f\uff08AJCC 7\u7248\u672c\uff09EGFR-M+ NSCLC\u60a3\u8005\u3002\u5f71\u50cf\u5b66\u968f\u8bbf\u7ed3\u5408\u57fa\u7ebf\uff08\u672f\u524d\uff09\u3001\u624b\u672f\u540e4\u5468\u548c\u968f\u8bbf\u76f4\u81f35\u5e74\u671f\u95f4\u4f7f\u7528\u6db2\u6ef4\u6570\u5b57PCR\u7eb5\u5411\u76d1\u6d4bctDNA\u3002\u4e3b\u8981\u7ec8\u70b9\u4e3a\u6839\u636e\u91cc\u7a0b\u7891\u70b9\u4e0actDNA\u9633\u6027\u72b6\u6001\u7684\u65e0\u75c5\u751f\u5b58\uff08DFS\uff09\u4ee5\u53cactDNA\u7eb5\u5411\u76d1\u6d4b\u7684\u654f\u611f\u6027\u3002<\/p>\n<\/div><\/div><\/div>
RESULTS \u7ed3\u679c<\/div><\/h4><\/div>Among 278 patients, pre-operative baseline ctDNA was detected in 67 (24%) patients: 23% (stage IA), 18% (IB), 18% (IIA), 50% (IIB), and 42% (IIIA) (p = 0.06). 76% (51 of 67) of patients with baseline ctDNA showed clearance at 4 weeks after surgery (post-operative). Patients were classified into three groups; Group A, baseline ctDNA negative (n = 211) vs Group B, baseline ctDNA positive but post-operative MRD negative (n = 51) vs Group C, baseline ctDNA positive and post-operative MRD positive (n = 16). The 3-year DFS rate was significantly different among the three groups (84% for Group A, 78% for Group B, and 50% for Group C, p = 0.02). After adjusting for clinicopathologic variables, ctDNA still remains an independent risk factor for DFS along with stage (p < 0.001) and micropapillary subtype (p = 0.02). With longitudinal monitoring of ctDNA, MRD was detected prior to radiological recurrence in 69% of patients with exon 19 del and in 20% with L858R mutation.<\/p>\n
\u5728278\u540d\u60a3\u8005\u4e2d\uff0c\u672f\u524d\u57fa\u7ebfctDNA\u68c0\u6d4b\u523067\u4f8b\uff0824%\uff09\u60a3\u8005\uff1a23%\uff08IA\u671f\uff09\u300118%\uff08IB\u671f\uff09\u300118%\uff08IIA\u671f\uff09\u300150%\uff08IIB\u671f\uff09\u548c42%\uff08IIIA\u671f\uff09\uff08p = 0.06\uff09\u3002\u5728\u624b\u672f\u540e4\u5468\uff0c67\u540d\u60a3\u8005\u4e2d76%\uff0851\u540d\uff09\u7684\u57fa\u7ebfctDNA\u6d88\u5931\uff08\u672f\u540eMRD\u9634\u6027\uff09\u3002\u60a3\u8005\u5206\u4e3a\u4e09\u7ec4\uff1aA\u7ec4\uff0c\u57fa\u7ebfctDNA\u9634\u6027\uff08n = 211\uff09\uff1bB\u7ec4\uff0c\u57fa\u7ebfctDNA\u9633\u6027\u4f46\u672f\u540eMRD\u9634\u6027\uff08n = 51\uff09\uff1bC\u7ec4\uff0c\u57fa\u7ebfctDNA\u9633\u6027\u4e14\u672f\u540eMRD\u9633\u6027\uff08n = 16\uff09\u3002\u4e09\u7ec4\u60a3\u8005\u76843\u5e74DFS\u7387\u663e\u8457\u4e0d\u540c\uff08A\u7ec4\u4e3a84%\uff0cB\u7ec4\u4e3a78%\uff0cC\u7ec4\u4e3a50%\uff0cp = 0.02\uff09\u3002\u5728\u8c03\u6574\u4e34\u5e8a\u75c5\u7406\u53d8\u91cf\u540e\uff0cctDNA\u4e0e\u5206\u671f\uff08p < 0.001\uff09\u548c\u5fae\u4e73\u5934\u4e9a\u578b\uff08p = 0.02\uff09\u4e00\u8d77\u4ecd\u7136\u662fDFS\u7684\u72ec\u7acb\u5371\u9669\u56e0\u7d20\u3002\u901a\u8fc7ctDNA\u7684\u7eb5\u5411\u76d1\u6d4b\uff0c\u572819\u53f7\u5916\u663e\u5b50\u7f3a\u5931\u578b\u7a81\u53d8\u4e2d\u670969%\u7684\u60a3\u8005\u5728\u5f71\u50cf\u5b66\u590d\u53d1\u4e4b\u524d\u68c0\u6d4b\u5230MRD\uff0c\u800c\u5728L858R\u7a81\u53d8\u4e2d\u670920%\u7684\u60a3\u8005\u68c0\u6d4b\u5230MRD\u3002<\/p>\n<\/div><\/div><\/div>
CONCLUSIONS \u7ed3\u8bba<\/div><\/h4><\/div>These results suggest that patients with baseline ctDNA-positive or MRD-positive status were associated with poor DFS in curative resected stage I-IIIA EGFR-M+ NSCLC, and that longitudinal monitoring of ctDNA, a non-invasive method, might be useful to detect early recurrence prior to radiological recurrence.<\/p>\n
\u8fd9\u4e9b\u7ed3\u679c\u8868\u660e\uff0c\u5728\u6839\u6cbb\u6027\u624b\u672f\u5207\u9664\u7684I-IIIA\u671fEGFR-M+ NSCLC\u60a3\u8005\u4e2d\uff0c\u57fa\u7ebfctDNA\u9633\u6027\u6216MRD\u9633\u6027\u72b6\u6001\u4e0e\u8f83\u5dee\u7684DFS\u76f8\u5173\uff0c\u5e76\u4e14ctDNA\u7684\u7eb5\u5411\u76d1\u6d4b\u4f5c\u4e3a\u4e00\u79cd\u975e\u4fb5\u5165\u6027\u65b9\u6cd5\uff0c\u53ef\u80fd\u6709\u52a9\u4e8e\u5728\u653e\u5c04\u5b66\u590d\u53d1\u4e4b\u524d\u68c0\u6d4b\u5230\u65e9\u671f\u590d\u53d1\u3002<\/p>\n
\u672c\u6587\u7ae0\u8f6c\u8f7d\u4e8e\uff1aSCI\u5929\u5929\u8bfb<\/p>\n
\u539f\u6587\u94fe\u63a5\uff1ahttps:\/\/mp.weixin.qq.com\/s\/nDkTVJLLmDPGPJz0dJqxow<\/p>\n<\/div><\/div><\/div><\/div><\/div><\/p>","protected":false},"excerpt":{"rendered":"
For patients with early-stage epidermal growth factor receptor mutation-positive (EGFR-M+) non-small cell lung cancer (NSCLC), adjuvant chemotherapy after radical surgery is considered the standard of care.<\/p>","protected":false},"author":1,"featured_media":3569,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_bbp_topic_count":0,"_bbp_reply_count":0,"_bbp_total_topic_count":0,"_bbp_total_reply_count":0,"_bbp_voice_count":0,"_bbp_anonymous_reply_count":0,"_bbp_topic_count_hidden":0,"_bbp_reply_count_hidden":0,"_bbp_forum_subforum_count":0,"content-type":"","om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[202],"tags":[],"class_list":["post-1336","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-202"],"acf":[],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/posts\/1336","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/comments?post=1336"}],"version-history":[{"count":5,"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/posts\/1336\/revisions"}],"predecessor-version":[{"id":3574,"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/posts\/1336\/revisions\/3574"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/media\/3569"}],"wp:attachment":[{"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/media?parent=1336"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/categories?post=1336"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/tags?post=1336"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
<\/span><\/div>INTRODUCTION \u4ecb\u7ecd<\/span><\/div><\/h4><\/div>For patients with early-stage epidermal growth factor receptor mutation positive (EGFR-M+) non-small cell lung cancer (NSCLC), curative surgery followed by adjuvant chemotherapy is considered the standard of care. This study assessed the feasibility and efficacy of longitudinal monitoring of circulating tumor DNA (ctDNA) as a valuable biomarker for early detection of minimal residual disease (MRD) and provides identification of the group at high-risk for recurrence in resected stage I-IIIA EGFR-M+ NSCLC.<\/p>\n
\u5bf9\u4e8e\u65e9\u671f\u8868\u76ae\u751f\u957f\u56e0\u5b50\u53d7\u4f53\u7a81\u53d8\u9633\u6027\uff08EGFR-M+\uff09\u975e\u5c0f\u7ec6\u80de\u80ba\u764c\uff08NSCLC\uff09\u60a3\u8005\uff0c\u6839\u6cbb\u6027\u624b\u672f\u540e\u8f85\u52a9\u5316\u7597\u88ab\u8ba4\u4e3a\u662f\u6807\u51c6\u6cbb\u7597\u65b9\u6cd5\u3002\u672c\u7814\u7a76\u8bc4\u4f30\u4e86\u5faa\u73af\u80bf\u7624DNA\uff08ctDNA\uff09\u7eb5\u5411\u76d1\u6d4b\u4f5c\u4e3a\u65e9\u671f\u5fae\u5c0f\u6b8b\u7559\u75c5\u7076\uff08MRD\uff09\u7684\u6709\u4ef7\u503c\u751f\u7269\u6807\u5fd7\u7269\u7684\u53ef\u884c\u6027\u548c\u7597\u6548\uff0c\u5e76\u786e\u5b9a\u4e86EGFR-M+ NSCLC\u624b\u672f\u5207\u9664\u7684I-IIIA\u671f\u60a3\u8005\u4e2d\u5177\u6709\u9ad8\u590d\u53d1\u98ce\u9669\u7684\u4eba\u7fa4\u3002<\/p>\n<\/div><\/div><\/div><\/div><\/div>
METHODS \u65b9\u6cd5<\/div><\/h4><\/div>Between August 2015 and October 2017, a total of 278 patients with curative resected, stage I-IIIA (AJCC 7 version) common EGFR-M+ NSCLC were analyzed. Radiological follow-up was accompanied with longitudinal monitoring of ctDNA using a droplet digital PCR from baseline (pre-operative), 4 weeks after curative surgery, and follow-up per protocol until 5 years. The primary outcomes were disease-free survival (DFS) according to the status of ctDNA positivity at landmark points and the sensitivity of longitudinal monitoring of ctDNA.<\/p>\n
\u5206\u6790\u4e862015\u5e748\u6708\u81f32017\u5e7410\u6708\u95f4\u5171278\u540d\u63a5\u53d7\u6839\u6cbb\u6027\u624b\u672f\u5207\u9664\u7684I-IIIA\u671f\uff08AJCC 7\u7248\u672c\uff09EGFR-M+ NSCLC\u60a3\u8005\u3002\u5f71\u50cf\u5b66\u968f\u8bbf\u7ed3\u5408\u57fa\u7ebf\uff08\u672f\u524d\uff09\u3001\u624b\u672f\u540e4\u5468\u548c\u968f\u8bbf\u76f4\u81f35\u5e74\u671f\u95f4\u4f7f\u7528\u6db2\u6ef4\u6570\u5b57PCR\u7eb5\u5411\u76d1\u6d4bctDNA\u3002\u4e3b\u8981\u7ec8\u70b9\u4e3a\u6839\u636e\u91cc\u7a0b\u7891\u70b9\u4e0actDNA\u9633\u6027\u72b6\u6001\u7684\u65e0\u75c5\u751f\u5b58\uff08DFS\uff09\u4ee5\u53cactDNA\u7eb5\u5411\u76d1\u6d4b\u7684\u654f\u611f\u6027\u3002<\/p>\n<\/div><\/div><\/div>
RESULTS \u7ed3\u679c<\/div><\/h4><\/div>Among 278 patients, pre-operative baseline ctDNA was detected in 67 (24%) patients: 23% (stage IA), 18% (IB), 18% (IIA), 50% (IIB), and 42% (IIIA) (p = 0.06). 76% (51 of 67) of patients with baseline ctDNA showed clearance at 4 weeks after surgery (post-operative). Patients were classified into three groups; Group A, baseline ctDNA negative (n = 211) vs Group B, baseline ctDNA positive but post-operative MRD negative (n = 51) vs Group C, baseline ctDNA positive and post-operative MRD positive (n = 16). The 3-year DFS rate was significantly different among the three groups (84% for Group A, 78% for Group B, and 50% for Group C, p = 0.02). After adjusting for clinicopathologic variables, ctDNA still remains an independent risk factor for DFS along with stage (p < 0.001) and micropapillary subtype (p = 0.02). With longitudinal monitoring of ctDNA, MRD was detected prior to radiological recurrence in 69% of patients with exon 19 del and in 20% with L858R mutation.<\/p>\n
\u5728278\u540d\u60a3\u8005\u4e2d\uff0c\u672f\u524d\u57fa\u7ebfctDNA\u68c0\u6d4b\u523067\u4f8b\uff0824%\uff09\u60a3\u8005\uff1a23%\uff08IA\u671f\uff09\u300118%\uff08IB\u671f\uff09\u300118%\uff08IIA\u671f\uff09\u300150%\uff08IIB\u671f\uff09\u548c42%\uff08IIIA\u671f\uff09\uff08p = 0.06\uff09\u3002\u5728\u624b\u672f\u540e4\u5468\uff0c67\u540d\u60a3\u8005\u4e2d76%\uff0851\u540d\uff09\u7684\u57fa\u7ebfctDNA\u6d88\u5931\uff08\u672f\u540eMRD\u9634\u6027\uff09\u3002\u60a3\u8005\u5206\u4e3a\u4e09\u7ec4\uff1aA\u7ec4\uff0c\u57fa\u7ebfctDNA\u9634\u6027\uff08n = 211\uff09\uff1bB\u7ec4\uff0c\u57fa\u7ebfctDNA\u9633\u6027\u4f46\u672f\u540eMRD\u9634\u6027\uff08n = 51\uff09\uff1bC\u7ec4\uff0c\u57fa\u7ebfctDNA\u9633\u6027\u4e14\u672f\u540eMRD\u9633\u6027\uff08n = 16\uff09\u3002\u4e09\u7ec4\u60a3\u8005\u76843\u5e74DFS\u7387\u663e\u8457\u4e0d\u540c\uff08A\u7ec4\u4e3a84%\uff0cB\u7ec4\u4e3a78%\uff0cC\u7ec4\u4e3a50%\uff0cp = 0.02\uff09\u3002\u5728\u8c03\u6574\u4e34\u5e8a\u75c5\u7406\u53d8\u91cf\u540e\uff0cctDNA\u4e0e\u5206\u671f\uff08p < 0.001\uff09\u548c\u5fae\u4e73\u5934\u4e9a\u578b\uff08p = 0.02\uff09\u4e00\u8d77\u4ecd\u7136\u662fDFS\u7684\u72ec\u7acb\u5371\u9669\u56e0\u7d20\u3002\u901a\u8fc7ctDNA\u7684\u7eb5\u5411\u76d1\u6d4b\uff0c\u572819\u53f7\u5916\u663e\u5b50\u7f3a\u5931\u578b\u7a81\u53d8\u4e2d\u670969%\u7684\u60a3\u8005\u5728\u5f71\u50cf\u5b66\u590d\u53d1\u4e4b\u524d\u68c0\u6d4b\u5230MRD\uff0c\u800c\u5728L858R\u7a81\u53d8\u4e2d\u670920%\u7684\u60a3\u8005\u68c0\u6d4b\u5230MRD\u3002<\/p>\n<\/div><\/div><\/div>
CONCLUSIONS \u7ed3\u8bba<\/div><\/h4><\/div>These results suggest that patients with baseline ctDNA-positive or MRD-positive status were associated with poor DFS in curative resected stage I-IIIA EGFR-M+ NSCLC, and that longitudinal monitoring of ctDNA, a non-invasive method, might be useful to detect early recurrence prior to radiological recurrence.<\/p>\n
\u8fd9\u4e9b\u7ed3\u679c\u8868\u660e\uff0c\u5728\u6839\u6cbb\u6027\u624b\u672f\u5207\u9664\u7684I-IIIA\u671fEGFR-M+ NSCLC\u60a3\u8005\u4e2d\uff0c\u57fa\u7ebfctDNA\u9633\u6027\u6216MRD\u9633\u6027\u72b6\u6001\u4e0e\u8f83\u5dee\u7684DFS\u76f8\u5173\uff0c\u5e76\u4e14ctDNA\u7684\u7eb5\u5411\u76d1\u6d4b\u4f5c\u4e3a\u4e00\u79cd\u975e\u4fb5\u5165\u6027\u65b9\u6cd5\uff0c\u53ef\u80fd\u6709\u52a9\u4e8e\u5728\u653e\u5c04\u5b66\u590d\u53d1\u4e4b\u524d\u68c0\u6d4b\u5230\u65e9\u671f\u590d\u53d1\u3002<\/p>\n
\u672c\u6587\u7ae0\u8f6c\u8f7d\u4e8e\uff1aSCI\u5929\u5929\u8bfb<\/p>\n
\u539f\u6587\u94fe\u63a5\uff1ahttps:\/\/mp.weixin.qq.com\/s\/nDkTVJLLmDPGPJz0dJqxow<\/p>\n<\/div><\/div><\/div><\/div><\/div><\/p>","protected":false},"excerpt":{"rendered":"
For patients with early-stage epidermal growth factor receptor mutation-positive (EGFR-M+) non-small cell lung cancer (NSCLC), adjuvant chemotherapy after radical surgery is considered the standard of care.<\/p>","protected":false},"author":1,"featured_media":3569,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_bbp_topic_count":0,"_bbp_reply_count":0,"_bbp_total_topic_count":0,"_bbp_total_reply_count":0,"_bbp_voice_count":0,"_bbp_anonymous_reply_count":0,"_bbp_topic_count_hidden":0,"_bbp_reply_count_hidden":0,"_bbp_forum_subforum_count":0,"content-type":"","om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[202],"tags":[],"class_list":["post-1336","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-202"],"acf":[],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/posts\/1336","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/comments?post=1336"}],"version-history":[{"count":5,"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/posts\/1336\/revisions"}],"predecessor-version":[{"id":3574,"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/posts\/1336\/revisions\/3574"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/media\/3569"}],"wp:attachment":[{"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/media?parent=1336"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/categories?post=1336"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/tags?post=1336"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
For patients with early-stage epidermal growth factor receptor mutation positive (EGFR-M+) non-small cell lung cancer (NSCLC), curative surgery followed by adjuvant chemotherapy is considered the standard of care. This study assessed the feasibility and efficacy of longitudinal monitoring of circulating tumor DNA (ctDNA) as a valuable biomarker for early detection of minimal residual disease (MRD) and provides identification of the group at high-risk for recurrence in resected stage I-IIIA EGFR-M+ NSCLC.<\/p>\n
\u5bf9\u4e8e\u65e9\u671f\u8868\u76ae\u751f\u957f\u56e0\u5b50\u53d7\u4f53\u7a81\u53d8\u9633\u6027\uff08EGFR-M+\uff09\u975e\u5c0f\u7ec6\u80de\u80ba\u764c\uff08NSCLC\uff09\u60a3\u8005\uff0c\u6839\u6cbb\u6027\u624b\u672f\u540e\u8f85\u52a9\u5316\u7597\u88ab\u8ba4\u4e3a\u662f\u6807\u51c6\u6cbb\u7597\u65b9\u6cd5\u3002\u672c\u7814\u7a76\u8bc4\u4f30\u4e86\u5faa\u73af\u80bf\u7624DNA\uff08ctDNA\uff09\u7eb5\u5411\u76d1\u6d4b\u4f5c\u4e3a\u65e9\u671f\u5fae\u5c0f\u6b8b\u7559\u75c5\u7076\uff08MRD\uff09\u7684\u6709\u4ef7\u503c\u751f\u7269\u6807\u5fd7\u7269\u7684\u53ef\u884c\u6027\u548c\u7597\u6548\uff0c\u5e76\u786e\u5b9a\u4e86EGFR-M+ NSCLC\u624b\u672f\u5207\u9664\u7684I-IIIA\u671f\u60a3\u8005\u4e2d\u5177\u6709\u9ad8\u590d\u53d1\u98ce\u9669\u7684\u4eba\u7fa4\u3002<\/p>\n<\/div><\/div><\/div><\/div><\/div>
METHODS \u65b9\u6cd5<\/div><\/h4><\/div>Between August 2015 and October 2017, a total of 278 patients with curative resected, stage I-IIIA (AJCC 7 version) common EGFR-M+ NSCLC were analyzed. Radiological follow-up was accompanied with longitudinal monitoring of ctDNA using a droplet digital PCR from baseline (pre-operative), 4 weeks after curative surgery, and follow-up per protocol until 5 years. The primary outcomes were disease-free survival (DFS) according to the status of ctDNA positivity at landmark points and the sensitivity of longitudinal monitoring of ctDNA.<\/p>\n
\u5206\u6790\u4e862015\u5e748\u6708\u81f32017\u5e7410\u6708\u95f4\u5171278\u540d\u63a5\u53d7\u6839\u6cbb\u6027\u624b\u672f\u5207\u9664\u7684I-IIIA\u671f\uff08AJCC 7\u7248\u672c\uff09EGFR-M+ NSCLC\u60a3\u8005\u3002\u5f71\u50cf\u5b66\u968f\u8bbf\u7ed3\u5408\u57fa\u7ebf\uff08\u672f\u524d\uff09\u3001\u624b\u672f\u540e4\u5468\u548c\u968f\u8bbf\u76f4\u81f35\u5e74\u671f\u95f4\u4f7f\u7528\u6db2\u6ef4\u6570\u5b57PCR\u7eb5\u5411\u76d1\u6d4bctDNA\u3002\u4e3b\u8981\u7ec8\u70b9\u4e3a\u6839\u636e\u91cc\u7a0b\u7891\u70b9\u4e0actDNA\u9633\u6027\u72b6\u6001\u7684\u65e0\u75c5\u751f\u5b58\uff08DFS\uff09\u4ee5\u53cactDNA\u7eb5\u5411\u76d1\u6d4b\u7684\u654f\u611f\u6027\u3002<\/p>\n<\/div><\/div><\/div>
RESULTS \u7ed3\u679c<\/div><\/h4><\/div>Among 278 patients, pre-operative baseline ctDNA was detected in 67 (24%) patients: 23% (stage IA), 18% (IB), 18% (IIA), 50% (IIB), and 42% (IIIA) (p = 0.06). 76% (51 of 67) of patients with baseline ctDNA showed clearance at 4 weeks after surgery (post-operative). Patients were classified into three groups; Group A, baseline ctDNA negative (n = 211) vs Group B, baseline ctDNA positive but post-operative MRD negative (n = 51) vs Group C, baseline ctDNA positive and post-operative MRD positive (n = 16). The 3-year DFS rate was significantly different among the three groups (84% for Group A, 78% for Group B, and 50% for Group C, p = 0.02). After adjusting for clinicopathologic variables, ctDNA still remains an independent risk factor for DFS along with stage (p < 0.001) and micropapillary subtype (p = 0.02). With longitudinal monitoring of ctDNA, MRD was detected prior to radiological recurrence in 69% of patients with exon 19 del and in 20% with L858R mutation.<\/p>\n
\u5728278\u540d\u60a3\u8005\u4e2d\uff0c\u672f\u524d\u57fa\u7ebfctDNA\u68c0\u6d4b\u523067\u4f8b\uff0824%\uff09\u60a3\u8005\uff1a23%\uff08IA\u671f\uff09\u300118%\uff08IB\u671f\uff09\u300118%\uff08IIA\u671f\uff09\u300150%\uff08IIB\u671f\uff09\u548c42%\uff08IIIA\u671f\uff09\uff08p = 0.06\uff09\u3002\u5728\u624b\u672f\u540e4\u5468\uff0c67\u540d\u60a3\u8005\u4e2d76%\uff0851\u540d\uff09\u7684\u57fa\u7ebfctDNA\u6d88\u5931\uff08\u672f\u540eMRD\u9634\u6027\uff09\u3002\u60a3\u8005\u5206\u4e3a\u4e09\u7ec4\uff1aA\u7ec4\uff0c\u57fa\u7ebfctDNA\u9634\u6027\uff08n = 211\uff09\uff1bB\u7ec4\uff0c\u57fa\u7ebfctDNA\u9633\u6027\u4f46\u672f\u540eMRD\u9634\u6027\uff08n = 51\uff09\uff1bC\u7ec4\uff0c\u57fa\u7ebfctDNA\u9633\u6027\u4e14\u672f\u540eMRD\u9633\u6027\uff08n = 16\uff09\u3002\u4e09\u7ec4\u60a3\u8005\u76843\u5e74DFS\u7387\u663e\u8457\u4e0d\u540c\uff08A\u7ec4\u4e3a84%\uff0cB\u7ec4\u4e3a78%\uff0cC\u7ec4\u4e3a50%\uff0cp = 0.02\uff09\u3002\u5728\u8c03\u6574\u4e34\u5e8a\u75c5\u7406\u53d8\u91cf\u540e\uff0cctDNA\u4e0e\u5206\u671f\uff08p < 0.001\uff09\u548c\u5fae\u4e73\u5934\u4e9a\u578b\uff08p = 0.02\uff09\u4e00\u8d77\u4ecd\u7136\u662fDFS\u7684\u72ec\u7acb\u5371\u9669\u56e0\u7d20\u3002\u901a\u8fc7ctDNA\u7684\u7eb5\u5411\u76d1\u6d4b\uff0c\u572819\u53f7\u5916\u663e\u5b50\u7f3a\u5931\u578b\u7a81\u53d8\u4e2d\u670969%\u7684\u60a3\u8005\u5728\u5f71\u50cf\u5b66\u590d\u53d1\u4e4b\u524d\u68c0\u6d4b\u5230MRD\uff0c\u800c\u5728L858R\u7a81\u53d8\u4e2d\u670920%\u7684\u60a3\u8005\u68c0\u6d4b\u5230MRD\u3002<\/p>\n<\/div><\/div><\/div>
CONCLUSIONS \u7ed3\u8bba<\/div><\/h4><\/div>These results suggest that patients with baseline ctDNA-positive or MRD-positive status were associated with poor DFS in curative resected stage I-IIIA EGFR-M+ NSCLC, and that longitudinal monitoring of ctDNA, a non-invasive method, might be useful to detect early recurrence prior to radiological recurrence.<\/p>\n
\u8fd9\u4e9b\u7ed3\u679c\u8868\u660e\uff0c\u5728\u6839\u6cbb\u6027\u624b\u672f\u5207\u9664\u7684I-IIIA\u671fEGFR-M+ NSCLC\u60a3\u8005\u4e2d\uff0c\u57fa\u7ebfctDNA\u9633\u6027\u6216MRD\u9633\u6027\u72b6\u6001\u4e0e\u8f83\u5dee\u7684DFS\u76f8\u5173\uff0c\u5e76\u4e14ctDNA\u7684\u7eb5\u5411\u76d1\u6d4b\u4f5c\u4e3a\u4e00\u79cd\u975e\u4fb5\u5165\u6027\u65b9\u6cd5\uff0c\u53ef\u80fd\u6709\u52a9\u4e8e\u5728\u653e\u5c04\u5b66\u590d\u53d1\u4e4b\u524d\u68c0\u6d4b\u5230\u65e9\u671f\u590d\u53d1\u3002<\/p>\n
\u672c\u6587\u7ae0\u8f6c\u8f7d\u4e8e\uff1aSCI\u5929\u5929\u8bfb<\/p>\n
\u539f\u6587\u94fe\u63a5\uff1ahttps:\/\/mp.weixin.qq.com\/s\/nDkTVJLLmDPGPJz0dJqxow<\/p>\n<\/div><\/div><\/div><\/div><\/div><\/p>","protected":false},"excerpt":{"rendered":"
For patients with early-stage epidermal growth factor receptor mutation-positive (EGFR-M+) non-small cell lung cancer (NSCLC), adjuvant chemotherapy after radical surgery is considered the standard of care.<\/p>","protected":false},"author":1,"featured_media":3569,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_bbp_topic_count":0,"_bbp_reply_count":0,"_bbp_total_topic_count":0,"_bbp_total_reply_count":0,"_bbp_voice_count":0,"_bbp_anonymous_reply_count":0,"_bbp_topic_count_hidden":0,"_bbp_reply_count_hidden":0,"_bbp_forum_subforum_count":0,"content-type":"","om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[202],"tags":[],"class_list":["post-1336","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-202"],"acf":[],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/posts\/1336","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/comments?post=1336"}],"version-history":[{"count":5,"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/posts\/1336\/revisions"}],"predecessor-version":[{"id":3574,"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/posts\/1336\/revisions\/3574"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/media\/3569"}],"wp:attachment":[{"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/media?parent=1336"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/categories?post=1336"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/tags?post=1336"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
Between August 2015 and October 2017, a total of 278 patients with curative resected, stage I-IIIA (AJCC 7 version) common EGFR-M+ NSCLC were analyzed. Radiological follow-up was accompanied with longitudinal monitoring of ctDNA using a droplet digital PCR from baseline (pre-operative), 4 weeks after curative surgery, and follow-up per protocol until 5 years. The primary outcomes were disease-free survival (DFS) according to the status of ctDNA positivity at landmark points and the sensitivity of longitudinal monitoring of ctDNA.<\/p>\n
\u5206\u6790\u4e862015\u5e748\u6708\u81f32017\u5e7410\u6708\u95f4\u5171278\u540d\u63a5\u53d7\u6839\u6cbb\u6027\u624b\u672f\u5207\u9664\u7684I-IIIA\u671f\uff08AJCC 7\u7248\u672c\uff09EGFR-M+ NSCLC\u60a3\u8005\u3002\u5f71\u50cf\u5b66\u968f\u8bbf\u7ed3\u5408\u57fa\u7ebf\uff08\u672f\u524d\uff09\u3001\u624b\u672f\u540e4\u5468\u548c\u968f\u8bbf\u76f4\u81f35\u5e74\u671f\u95f4\u4f7f\u7528\u6db2\u6ef4\u6570\u5b57PCR\u7eb5\u5411\u76d1\u6d4bctDNA\u3002\u4e3b\u8981\u7ec8\u70b9\u4e3a\u6839\u636e\u91cc\u7a0b\u7891\u70b9\u4e0actDNA\u9633\u6027\u72b6\u6001\u7684\u65e0\u75c5\u751f\u5b58\uff08DFS\uff09\u4ee5\u53cactDNA\u7eb5\u5411\u76d1\u6d4b\u7684\u654f\u611f\u6027\u3002<\/p>\n<\/div><\/div><\/div>
RESULTS \u7ed3\u679c<\/div><\/h4><\/div>Among 278 patients, pre-operative baseline ctDNA was detected in 67 (24%) patients: 23% (stage IA), 18% (IB), 18% (IIA), 50% (IIB), and 42% (IIIA) (p = 0.06). 76% (51 of 67) of patients with baseline ctDNA showed clearance at 4 weeks after surgery (post-operative). Patients were classified into three groups; Group A, baseline ctDNA negative (n = 211) vs Group B, baseline ctDNA positive but post-operative MRD negative (n = 51) vs Group C, baseline ctDNA positive and post-operative MRD positive (n = 16). The 3-year DFS rate was significantly different among the three groups (84% for Group A, 78% for Group B, and 50% for Group C, p = 0.02). After adjusting for clinicopathologic variables, ctDNA still remains an independent risk factor for DFS along with stage (p < 0.001) and micropapillary subtype (p = 0.02). With longitudinal monitoring of ctDNA, MRD was detected prior to radiological recurrence in 69% of patients with exon 19 del and in 20% with L858R mutation.<\/p>\n
\u5728278\u540d\u60a3\u8005\u4e2d\uff0c\u672f\u524d\u57fa\u7ebfctDNA\u68c0\u6d4b\u523067\u4f8b\uff0824%\uff09\u60a3\u8005\uff1a23%\uff08IA\u671f\uff09\u300118%\uff08IB\u671f\uff09\u300118%\uff08IIA\u671f\uff09\u300150%\uff08IIB\u671f\uff09\u548c42%\uff08IIIA\u671f\uff09\uff08p = 0.06\uff09\u3002\u5728\u624b\u672f\u540e4\u5468\uff0c67\u540d\u60a3\u8005\u4e2d76%\uff0851\u540d\uff09\u7684\u57fa\u7ebfctDNA\u6d88\u5931\uff08\u672f\u540eMRD\u9634\u6027\uff09\u3002\u60a3\u8005\u5206\u4e3a\u4e09\u7ec4\uff1aA\u7ec4\uff0c\u57fa\u7ebfctDNA\u9634\u6027\uff08n = 211\uff09\uff1bB\u7ec4\uff0c\u57fa\u7ebfctDNA\u9633\u6027\u4f46\u672f\u540eMRD\u9634\u6027\uff08n = 51\uff09\uff1bC\u7ec4\uff0c\u57fa\u7ebfctDNA\u9633\u6027\u4e14\u672f\u540eMRD\u9633\u6027\uff08n = 16\uff09\u3002\u4e09\u7ec4\u60a3\u8005\u76843\u5e74DFS\u7387\u663e\u8457\u4e0d\u540c\uff08A\u7ec4\u4e3a84%\uff0cB\u7ec4\u4e3a78%\uff0cC\u7ec4\u4e3a50%\uff0cp = 0.02\uff09\u3002\u5728\u8c03\u6574\u4e34\u5e8a\u75c5\u7406\u53d8\u91cf\u540e\uff0cctDNA\u4e0e\u5206\u671f\uff08p < 0.001\uff09\u548c\u5fae\u4e73\u5934\u4e9a\u578b\uff08p = 0.02\uff09\u4e00\u8d77\u4ecd\u7136\u662fDFS\u7684\u72ec\u7acb\u5371\u9669\u56e0\u7d20\u3002\u901a\u8fc7ctDNA\u7684\u7eb5\u5411\u76d1\u6d4b\uff0c\u572819\u53f7\u5916\u663e\u5b50\u7f3a\u5931\u578b\u7a81\u53d8\u4e2d\u670969%\u7684\u60a3\u8005\u5728\u5f71\u50cf\u5b66\u590d\u53d1\u4e4b\u524d\u68c0\u6d4b\u5230MRD\uff0c\u800c\u5728L858R\u7a81\u53d8\u4e2d\u670920%\u7684\u60a3\u8005\u68c0\u6d4b\u5230MRD\u3002<\/p>\n<\/div><\/div><\/div>
CONCLUSIONS \u7ed3\u8bba<\/div><\/h4><\/div>These results suggest that patients with baseline ctDNA-positive or MRD-positive status were associated with poor DFS in curative resected stage I-IIIA EGFR-M+ NSCLC, and that longitudinal monitoring of ctDNA, a non-invasive method, might be useful to detect early recurrence prior to radiological recurrence.<\/p>\n
\u8fd9\u4e9b\u7ed3\u679c\u8868\u660e\uff0c\u5728\u6839\u6cbb\u6027\u624b\u672f\u5207\u9664\u7684I-IIIA\u671fEGFR-M+ NSCLC\u60a3\u8005\u4e2d\uff0c\u57fa\u7ebfctDNA\u9633\u6027\u6216MRD\u9633\u6027\u72b6\u6001\u4e0e\u8f83\u5dee\u7684DFS\u76f8\u5173\uff0c\u5e76\u4e14ctDNA\u7684\u7eb5\u5411\u76d1\u6d4b\u4f5c\u4e3a\u4e00\u79cd\u975e\u4fb5\u5165\u6027\u65b9\u6cd5\uff0c\u53ef\u80fd\u6709\u52a9\u4e8e\u5728\u653e\u5c04\u5b66\u590d\u53d1\u4e4b\u524d\u68c0\u6d4b\u5230\u65e9\u671f\u590d\u53d1\u3002<\/p>\n
\u672c\u6587\u7ae0\u8f6c\u8f7d\u4e8e\uff1aSCI\u5929\u5929\u8bfb<\/p>\n
\u539f\u6587\u94fe\u63a5\uff1ahttps:\/\/mp.weixin.qq.com\/s\/nDkTVJLLmDPGPJz0dJqxow<\/p>\n<\/div><\/div><\/div><\/div><\/div><\/p>","protected":false},"excerpt":{"rendered":"
For patients with early-stage epidermal growth factor receptor mutation-positive (EGFR-M+) non-small cell lung cancer (NSCLC), adjuvant chemotherapy after radical surgery is considered the standard of care.<\/p>","protected":false},"author":1,"featured_media":3569,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_bbp_topic_count":0,"_bbp_reply_count":0,"_bbp_total_topic_count":0,"_bbp_total_reply_count":0,"_bbp_voice_count":0,"_bbp_anonymous_reply_count":0,"_bbp_topic_count_hidden":0,"_bbp_reply_count_hidden":0,"_bbp_forum_subforum_count":0,"content-type":"","om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[202],"tags":[],"class_list":["post-1336","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-202"],"acf":[],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/posts\/1336","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/comments?post=1336"}],"version-history":[{"count":5,"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/posts\/1336\/revisions"}],"predecessor-version":[{"id":3574,"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/posts\/1336\/revisions\/3574"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/media\/3569"}],"wp:attachment":[{"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/media?parent=1336"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/categories?post=1336"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/tags?post=1336"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
Among 278 patients, pre-operative baseline ctDNA was detected in 67 (24%) patients: 23% (stage IA), 18% (IB), 18% (IIA), 50% (IIB), and 42% (IIIA) (p = 0.06). 76% (51 of 67) of patients with baseline ctDNA showed clearance at 4 weeks after surgery (post-operative). Patients were classified into three groups; Group A, baseline ctDNA negative (n = 211) vs Group B, baseline ctDNA positive but post-operative MRD negative (n = 51) vs Group C, baseline ctDNA positive and post-operative MRD positive (n = 16). The 3-year DFS rate was significantly different among the three groups (84% for Group A, 78% for Group B, and 50% for Group C, p = 0.02). After adjusting for clinicopathologic variables, ctDNA still remains an independent risk factor for DFS along with stage (p < 0.001) and micropapillary subtype (p = 0.02). With longitudinal monitoring of ctDNA, MRD was detected prior to radiological recurrence in 69% of patients with exon 19 del and in 20% with L858R mutation.<\/p>\n
\u5728278\u540d\u60a3\u8005\u4e2d\uff0c\u672f\u524d\u57fa\u7ebfctDNA\u68c0\u6d4b\u523067\u4f8b\uff0824%\uff09\u60a3\u8005\uff1a23%\uff08IA\u671f\uff09\u300118%\uff08IB\u671f\uff09\u300118%\uff08IIA\u671f\uff09\u300150%\uff08IIB\u671f\uff09\u548c42%\uff08IIIA\u671f\uff09\uff08p = 0.06\uff09\u3002\u5728\u624b\u672f\u540e4\u5468\uff0c67\u540d\u60a3\u8005\u4e2d76%\uff0851\u540d\uff09\u7684\u57fa\u7ebfctDNA\u6d88\u5931\uff08\u672f\u540eMRD\u9634\u6027\uff09\u3002\u60a3\u8005\u5206\u4e3a\u4e09\u7ec4\uff1aA\u7ec4\uff0c\u57fa\u7ebfctDNA\u9634\u6027\uff08n = 211\uff09\uff1bB\u7ec4\uff0c\u57fa\u7ebfctDNA\u9633\u6027\u4f46\u672f\u540eMRD\u9634\u6027\uff08n = 51\uff09\uff1bC\u7ec4\uff0c\u57fa\u7ebfctDNA\u9633\u6027\u4e14\u672f\u540eMRD\u9633\u6027\uff08n = 16\uff09\u3002\u4e09\u7ec4\u60a3\u8005\u76843\u5e74DFS\u7387\u663e\u8457\u4e0d\u540c\uff08A\u7ec4\u4e3a84%\uff0cB\u7ec4\u4e3a78%\uff0cC\u7ec4\u4e3a50%\uff0cp = 0.02\uff09\u3002\u5728\u8c03\u6574\u4e34\u5e8a\u75c5\u7406\u53d8\u91cf\u540e\uff0cctDNA\u4e0e\u5206\u671f\uff08p < 0.001\uff09\u548c\u5fae\u4e73\u5934\u4e9a\u578b\uff08p = 0.02\uff09\u4e00\u8d77\u4ecd\u7136\u662fDFS\u7684\u72ec\u7acb\u5371\u9669\u56e0\u7d20\u3002\u901a\u8fc7ctDNA\u7684\u7eb5\u5411\u76d1\u6d4b\uff0c\u572819\u53f7\u5916\u663e\u5b50\u7f3a\u5931\u578b\u7a81\u53d8\u4e2d\u670969%\u7684\u60a3\u8005\u5728\u5f71\u50cf\u5b66\u590d\u53d1\u4e4b\u524d\u68c0\u6d4b\u5230MRD\uff0c\u800c\u5728L858R\u7a81\u53d8\u4e2d\u670920%\u7684\u60a3\u8005\u68c0\u6d4b\u5230MRD\u3002<\/p>\n<\/div><\/div><\/div>
CONCLUSIONS \u7ed3\u8bba<\/div><\/h4><\/div>These results suggest that patients with baseline ctDNA-positive or MRD-positive status were associated with poor DFS in curative resected stage I-IIIA EGFR-M+ NSCLC, and that longitudinal monitoring of ctDNA, a non-invasive method, might be useful to detect early recurrence prior to radiological recurrence.<\/p>\n
\u8fd9\u4e9b\u7ed3\u679c\u8868\u660e\uff0c\u5728\u6839\u6cbb\u6027\u624b\u672f\u5207\u9664\u7684I-IIIA\u671fEGFR-M+ NSCLC\u60a3\u8005\u4e2d\uff0c\u57fa\u7ebfctDNA\u9633\u6027\u6216MRD\u9633\u6027\u72b6\u6001\u4e0e\u8f83\u5dee\u7684DFS\u76f8\u5173\uff0c\u5e76\u4e14ctDNA\u7684\u7eb5\u5411\u76d1\u6d4b\u4f5c\u4e3a\u4e00\u79cd\u975e\u4fb5\u5165\u6027\u65b9\u6cd5\uff0c\u53ef\u80fd\u6709\u52a9\u4e8e\u5728\u653e\u5c04\u5b66\u590d\u53d1\u4e4b\u524d\u68c0\u6d4b\u5230\u65e9\u671f\u590d\u53d1\u3002<\/p>\n
\u672c\u6587\u7ae0\u8f6c\u8f7d\u4e8e\uff1aSCI\u5929\u5929\u8bfb<\/p>\n
\u539f\u6587\u94fe\u63a5\uff1ahttps:\/\/mp.weixin.qq.com\/s\/nDkTVJLLmDPGPJz0dJqxow<\/p>\n<\/div><\/div><\/div><\/div><\/div><\/p>","protected":false},"excerpt":{"rendered":"
For patients with early-stage epidermal growth factor receptor mutation-positive (EGFR-M+) non-small cell lung cancer (NSCLC), adjuvant chemotherapy after radical surgery is considered the standard of care.<\/p>","protected":false},"author":1,"featured_media":3569,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_bbp_topic_count":0,"_bbp_reply_count":0,"_bbp_total_topic_count":0,"_bbp_total_reply_count":0,"_bbp_voice_count":0,"_bbp_anonymous_reply_count":0,"_bbp_topic_count_hidden":0,"_bbp_reply_count_hidden":0,"_bbp_forum_subforum_count":0,"content-type":"","om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[202],"tags":[],"class_list":["post-1336","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-202"],"acf":[],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/posts\/1336","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/comments?post=1336"}],"version-history":[{"count":5,"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/posts\/1336\/revisions"}],"predecessor-version":[{"id":3574,"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/posts\/1336\/revisions\/3574"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/media\/3569"}],"wp:attachment":[{"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/media?parent=1336"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/categories?post=1336"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/tags?post=1336"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
These results suggest that patients with baseline ctDNA-positive or MRD-positive status were associated with poor DFS in curative resected stage I-IIIA EGFR-M+ NSCLC, and that longitudinal monitoring of ctDNA, a non-invasive method, might be useful to detect early recurrence prior to radiological recurrence.<\/p>\n
\u8fd9\u4e9b\u7ed3\u679c\u8868\u660e\uff0c\u5728\u6839\u6cbb\u6027\u624b\u672f\u5207\u9664\u7684I-IIIA\u671fEGFR-M+ NSCLC\u60a3\u8005\u4e2d\uff0c\u57fa\u7ebfctDNA\u9633\u6027\u6216MRD\u9633\u6027\u72b6\u6001\u4e0e\u8f83\u5dee\u7684DFS\u76f8\u5173\uff0c\u5e76\u4e14ctDNA\u7684\u7eb5\u5411\u76d1\u6d4b\u4f5c\u4e3a\u4e00\u79cd\u975e\u4fb5\u5165\u6027\u65b9\u6cd5\uff0c\u53ef\u80fd\u6709\u52a9\u4e8e\u5728\u653e\u5c04\u5b66\u590d\u53d1\u4e4b\u524d\u68c0\u6d4b\u5230\u65e9\u671f\u590d\u53d1\u3002<\/p>\n
\u672c\u6587\u7ae0\u8f6c\u8f7d\u4e8e\uff1aSCI\u5929\u5929\u8bfb<\/p>\n
\u539f\u6587\u94fe\u63a5\uff1ahttps:\/\/mp.weixin.qq.com\/s\/nDkTVJLLmDPGPJz0dJqxow<\/p>\n<\/div><\/div><\/div><\/div><\/div><\/p>","protected":false},"excerpt":{"rendered":"
For patients with early-stage epidermal growth factor receptor mutation-positive (EGFR-M+) non-small cell lung cancer (NSCLC), adjuvant chemotherapy after radical surgery is considered the standard of care.<\/p>","protected":false},"author":1,"featured_media":3569,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_bbp_topic_count":0,"_bbp_reply_count":0,"_bbp_total_topic_count":0,"_bbp_total_reply_count":0,"_bbp_voice_count":0,"_bbp_anonymous_reply_count":0,"_bbp_topic_count_hidden":0,"_bbp_reply_count_hidden":0,"_bbp_forum_subforum_count":0,"content-type":"","om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[202],"tags":[],"class_list":["post-1336","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-202"],"acf":[],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/posts\/1336","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/comments?post=1336"}],"version-history":[{"count":5,"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/posts\/1336\/revisions"}],"predecessor-version":[{"id":3574,"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/posts\/1336\/revisions\/3574"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/media\/3569"}],"wp:attachment":[{"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/media?parent=1336"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/categories?post=1336"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.funcbio.cn\/en\/wp-json\/wp\/v2\/tags?post=1336"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}