中山大学Ying Sun等合作，近期取得重要工作进展。他们研究提出了将纵向治疗循环肿瘤DNA作为癌症患者实时动态风险监测的生物标记物：EP-SEASON研究 。相关研究成果2024年7月25日在线发表于《癌细胞》杂志上。

据介绍，癌症患者的复发风险在治疗过程中可能会因治疗相关的肿瘤演变而发生变化。然而，目前还缺乏能够监测这些变化的生物标志物。

研究人员探讨了通过液体活检追踪循环肿瘤DNA（ctDNA）动态是否可以实时告知复发风险。鼻咽癌（NPC）提供了一种理想的模型，可以灵敏地检测无细胞EB病毒（EBV）DNA（cfEBV DNA），一种ctDNA。

研究人员进行了EP-SEASON研究（NCT03855020），前瞻性招募了1000名鼻咽癌患者，他们在11个时间点接受了符合方案的cfEBV DNA评估，并接受了序贯化放疗。在新辅助化疗和放疗期间，纵向cfEBV DNA显示出不同的模式。尽管cfEBV DNA在每个时间点都具有预后意义，但实时复发风险与cfEBV的DNA动态同步变化。

此外，研究人员还确定了与不同生存结果相关的全程ctDNA变化动力学的表型。

总之，总之，对治疗中的ctDNA进行纵向追踪可以实时预测复发风险，从而促进适应风险的个体化患者管理。

附：英文原文

Title: Longitudinal on-treatment circulating tumor DNA as a biomarker for real-time dynamic risk monitoring in cancer patients: The EP-SEASON study

Author: Jiawei Lv, Ling-Xin Xu, Zhi-Xuan Li, Li Lin, Chen-Fei Wu, Ting-Qiu Quan, Zi-Cheng Zhen, Wen-Fei Li, Ling-Long Tang, Yan-Ping Mao, Lei Chen, Rui Guo, Lu-Lu Zhang, Xin-Lei Ai, Shi-Yue Wu, Meng-Yu Hao, Denghui Wei, Ji-Bin Li, Jun Ma, Yu-Pei Chen, Guan-Qun Zhou, Ying Sun

Issue&Volume: 2024-07-25

Abstract: Recurrence risks of cancer patient can change during treatment as a result of treatment-related tumor evolution. However, biomarkers that can monitor these changes are lacking. Here, we investigated whether tracking circulating tumor DNA (ctDNA) dynamics through liquid biopsy can inform real-time recurrence risk. Nasopharyngeal carcinoma (NPC) provides an ideal model where cell-free Epstein-Barr virus (EBV) DNA (cfEBV DNA), a ctDNA, can be sensitively detected. We conducted the EP-SEASON study (NCT03855020) and prospectively recruited 1,000 NPC patients undergoing per-protocol cfEBV DNA assessments at 11 time points and receiving sequential chemo-radiotherapy. Longitudinal cfEBV DNA displayed distinct patterns during neoadjuvant chemotherapy and radiotherapy. Despite the prognostic significance of cfEBV DNA at each time point, real-time recurrence risks changed in sync with cfEBV DNA dynamics. Furthermore, we identified phenotypes of whole-course ctDNA changing dynamics associated with different survival outcomes. In conclusion, tracking longitudinal on-treatment ctDNA can forecast real-time recurrence risk, facilitating risk-adapted, individualized patient management.

DOI: 10.1016/j.ccell.2024.07.001

Source: https://www.cell.com/cancer-cell/fulltext/S1535-6108(24)00266-6