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Mutations in circulating tumor DNA detected in the postoperative period predict poor survival in patients with ovarian cancer.


ABSTRACT:

Background

We investigated whether mutations in plasma circulating tumor DNA (ctDNA) can provide prognostic insight in patients with different histological types of ovarian carcinoma. We also examined the concordance of mutations detected in ctDNA samples with those identified in the corresponding formalin-fixed paraffin-embedded (FFPE) tumor specimens.

Methods

Between July 2016 and December 2017, 29 patients with ovarian carcinoma were prospectively enrolled. FFPE tumor specimens were obtained from all participants. A total of 187 blood samples for ctDNA analysis were collected before surgery (C0), immediate after surgery before adjuvant chemotherapy (C1), and at six-month intervals. Progression-free survival (PFS) and overall survival (OS) served as the main outcome measures.

Results

The study cohort consisted of 13 (44.8%) patients with high-grade serous carcinomas (HGSC), 9 (31.0%) with clear cell carcinoma, 2 (6.9%) with mucinous carcinomas, 4 (13.8%) with low-grade serous carcinomas, and 1 (3.4%) with endometrioid carcinoma. Twenty-four (82.8%) patients had at least one detectable ctDNA variant. The concordance rate between mutations identified in pretreatment ctDNA and corresponding FFPE tumor specimens was 92.3% for patients with HGSC and 58.6% for the entire cohort. The median follow-up time was 33.15 months (range: 0.79-46.13 months). Patients with an advanced stage disease more likely had detectable ctDNA mutations before surgery (C0) and after surgery at C1, while those with HGSC more likely had ctDNA mutations detected before surgery. The presence of ctDNA mutations at C1 was an independent predictor of worse OS with a hazard ratio of 6.56 (95% confidence interval, (1.07-40.17) for detectable versus undetectable C1 ctDNA variants, p = 0.042).

Conclusions

ctDNA mutations are common in patients with ovarian carcinoma. The presence of ctDNA mutations after surgery was an independent predictor of less favorable PFS and OS.

SUBMITTER: Chao A 

PROVIDER: S-EPMC10498401 | biostudies-literature | 2022 Oct

REPOSITORIES: biostudies-literature

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Mutations in circulating tumor DNA detected in the postoperative period predict poor survival in patients with ovarian cancer.

Chao Angel A   Chen Shu-Jen SJ   Chen Hua-Chien HC   Tan Kien Thiam KT   Hsiao Wen W   Jung Shih-Ming SM   Yang Lan-Yan LY   Huang Kuan-Gen KG   Chou Hung-Hsueh HH   Huang Huei-Jean HJ   Chang Ting-Chang TC   Chao An-Shine AS   Lee Yun-Hsien YH   Wu Ren-Chin RC   Lai Chyong-Huey CH  

Biomedical journal 20221005 5


<h4>Background</h4>We investigated whether mutations in plasma circulating tumor DNA (ctDNA) can provide prognostic insight in patients with different histological types of ovarian carcinoma. We also examined the concordance of mutations detected in ctDNA samples with those identified in the corresponding formalin-fixed paraffin-embedded (FFPE) tumor specimens.<h4>Methods</h4>Between July 2016 and December 2017, 29 patients with ovarian carcinoma were prospectively enrolled. FFPE tumor specimens  ...[more]

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