Circulating DNA in patients undergoing loco-regional treatment of colorectal cancer metastases: a systematic review and meta-analysis
Background: Loco-regional treatment strategies of colorectal cancer (CRC) metastases are evolving, but biological markers that can benefit patients and assist physicians in clinical decisions are lacking. The primary objective of this systematic review and meta-analysis is to investigate the current...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2022-11-01
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| Series: | Therapeutic Advances in Medical Oncology |
| Online Access: | https://doi.org/10.1177/17588359221133171 |
| _version_ | 1797990287303245824 |
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| author | Louise B. Callesen Tana Takacova Julian Hamfjord Florian Würschmidt Karl J. Oldhafer Roland Brüning Dirk Arnold Karen-Lise G. Spindler |
| author_facet | Louise B. Callesen Tana Takacova Julian Hamfjord Florian Würschmidt Karl J. Oldhafer Roland Brüning Dirk Arnold Karen-Lise G. Spindler |
| author_sort | Louise B. Callesen |
| collection | DOAJ |
| description | Background: Loco-regional treatment strategies of colorectal cancer (CRC) metastases are evolving, but biological markers that can benefit patients and assist physicians in clinical decisions are lacking. The primary objective of this systematic review and meta-analysis is to investigate the current knowledge on circulating DNA and its clinical utility in predicting outcomes in patients undergoing loco-regional treatment of CRC metastases. Methods: A systematic search of PubMed, Embase, and Cochrane Central Register of Controlled Trials was conducted on March 22, 2022. We included studies on patients undergoing loco-regional treatment of CRC metastases reporting the predictive or prognostic value of circulating DNA in the blood. Hazard ratios (HR) were pooled in separate random-effects meta-analyses to investigate if pre- or post-ablation measurements of circulating DNA were associated with survival. The risk of bias was assessed according to the Quality in Prognosis Studies tool. Results: Twenty-eight studies with 2868 patients were included, of which 16 studies were eligible for meta-analyses. As expected in this new research field, a majority of included studies ( n = 21/28) had a high risk of bias in at least one domain. Circulating DNA above the cutoff in a plasma sample taken before loco-regional treatment was associated with a short recurrence-free survival [pooled HR = 2.8, 95% confidence interval (CI) 1.4–5.7, n = 162] and overall survival (pooled HR = 4.7, 95% CI 1.1–20.6, n = 105). Circulating DNA above the cutoff in a plasma sample taken after loco-regional treatment was associated with a short recurrence-free survival (pooled HR = 4.5, 95% CI 3.4–6.1, n = 569) and overall survival (pooled HR = 7.5, 95% CI 2.0–27.3, n = 161). There was limited data on the association between dynamics in circulating DNA and outcome. Conclusions: Measurements of circulating DNA can be valuable when selecting and monitoring patients undergoing loco-regional treatment of CRC metastases. Studies designed to investigate the true clinical utility of circulating DNA in the context of various ablation modalities are warranted. The review has been registered at PROSPERO (ID: CRD42022320032) |
| first_indexed | 2024-04-11T08:33:03Z |
| format | Article |
| id | doaj.art-1e211deeeccc462695b4b46b1f1e5d3d |
| institution | Directory Open Access Journal |
| issn | 1758-8359 |
| language | English |
| last_indexed | 2024-04-11T08:33:03Z |
| publishDate | 2022-11-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Therapeutic Advances in Medical Oncology |
| spelling | doaj.art-1e211deeeccc462695b4b46b1f1e5d3d2022-12-22T04:34:24ZengSAGE PublishingTherapeutic Advances in Medical Oncology1758-83592022-11-011410.1177/17588359221133171Circulating DNA in patients undergoing loco-regional treatment of colorectal cancer metastases: a systematic review and meta-analysisLouise B. CallesenTana TakacovaJulian HamfjordFlorian WürschmidtKarl J. OldhaferRoland BrüningDirk ArnoldKaren-Lise G. SpindlerBackground: Loco-regional treatment strategies of colorectal cancer (CRC) metastases are evolving, but biological markers that can benefit patients and assist physicians in clinical decisions are lacking. The primary objective of this systematic review and meta-analysis is to investigate the current knowledge on circulating DNA and its clinical utility in predicting outcomes in patients undergoing loco-regional treatment of CRC metastases. Methods: A systematic search of PubMed, Embase, and Cochrane Central Register of Controlled Trials was conducted on March 22, 2022. We included studies on patients undergoing loco-regional treatment of CRC metastases reporting the predictive or prognostic value of circulating DNA in the blood. Hazard ratios (HR) were pooled in separate random-effects meta-analyses to investigate if pre- or post-ablation measurements of circulating DNA were associated with survival. The risk of bias was assessed according to the Quality in Prognosis Studies tool. Results: Twenty-eight studies with 2868 patients were included, of which 16 studies were eligible for meta-analyses. As expected in this new research field, a majority of included studies ( n = 21/28) had a high risk of bias in at least one domain. Circulating DNA above the cutoff in a plasma sample taken before loco-regional treatment was associated with a short recurrence-free survival [pooled HR = 2.8, 95% confidence interval (CI) 1.4–5.7, n = 162] and overall survival (pooled HR = 4.7, 95% CI 1.1–20.6, n = 105). Circulating DNA above the cutoff in a plasma sample taken after loco-regional treatment was associated with a short recurrence-free survival (pooled HR = 4.5, 95% CI 3.4–6.1, n = 569) and overall survival (pooled HR = 7.5, 95% CI 2.0–27.3, n = 161). There was limited data on the association between dynamics in circulating DNA and outcome. Conclusions: Measurements of circulating DNA can be valuable when selecting and monitoring patients undergoing loco-regional treatment of CRC metastases. Studies designed to investigate the true clinical utility of circulating DNA in the context of various ablation modalities are warranted. The review has been registered at PROSPERO (ID: CRD42022320032)https://doi.org/10.1177/17588359221133171 |
| spellingShingle | Louise B. Callesen Tana Takacova Julian Hamfjord Florian Würschmidt Karl J. Oldhafer Roland Brüning Dirk Arnold Karen-Lise G. Spindler Circulating DNA in patients undergoing loco-regional treatment of colorectal cancer metastases: a systematic review and meta-analysis Therapeutic Advances in Medical Oncology |
| title | Circulating DNA in patients undergoing loco-regional treatment of colorectal cancer metastases: a systematic review and meta-analysis |
| title_full | Circulating DNA in patients undergoing loco-regional treatment of colorectal cancer metastases: a systematic review and meta-analysis |
| title_fullStr | Circulating DNA in patients undergoing loco-regional treatment of colorectal cancer metastases: a systematic review and meta-analysis |
| title_full_unstemmed | Circulating DNA in patients undergoing loco-regional treatment of colorectal cancer metastases: a systematic review and meta-analysis |
| title_short | Circulating DNA in patients undergoing loco-regional treatment of colorectal cancer metastases: a systematic review and meta-analysis |
| title_sort | circulating dna in patients undergoing loco regional treatment of colorectal cancer metastases a systematic review and meta analysis |
| url | https://doi.org/10.1177/17588359221133171 |
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