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Among 135 patients, those with detectable tumour DNA in blood lived 6.5 months against 19, and the more of it there was the shorter the survival; after surgery, finding it predicted early recurrence.
Blood samples were prospectively collected from consecutive pancreatic adenocarcinoma patients treated at one centre from 2011 to 2015, with circulating tumour DNA identified by targeted next-generation sequencing and picolitre droplet digital PCR. Of 135 patients (31 resectable, 36 locally advanced, 68 metastatic), 50 of 104 with advanced disease (48%) had detectable ctDNA at a median mutant allele fraction of 6.1%. Detection correlated strongly with poor overall survival (6.5 versus 19.0 months; multivariate hazard ratio 1.96), and allele-fraction tertiles gave 18.9, 7.8 and 4.9 months. Among 31 patients resected with curative intent, 6 had detectable ctDNA after surgery at a mean allele fraction of 4.4%, with shorter disease-free (4.6 versus 17.6 months) and overall survival (19.3 versus 32.2 months).
ctDNA quantity, not just presence, grades prognosis, which is why trials now stratify by allele fraction rather than by a yes or no.
Shares ctDNA MRD positivity (molecular residual disease after curative treatment), Clinical Cancer Research, Minimal / molecular residual disease (MRD), Circulating tumour DNA (ctDNA).
Shares Cell-free DNA (cfDNA), ctDNA MRD positivity (molecular residual disease after curative treatment), Minimal / molecular residual disease (MRD), Circulating tumour DNA (ctDNA).
Shares ctDNA MRD positivity (molecular residual disease after curative treatment), Minimal / molecular residual disease (MRD), Circulating tumour DNA (ctDNA), Resectable pancreatic ductal adenocarcinoma.
Shares Cell-free DNA (cfDNA), ctDNA MRD positivity (molecular residual disease after curative treatment), Circulating tumour DNA (ctDNA), Liquid biopsy (ctDNA).
Shares ctDNA MRD positivity (molecular residual disease after curative treatment), Minimal / molecular residual disease (MRD), Circulating tumour DNA (ctDNA), MRD / molecular residual disease testing.
Shares Minimal / molecular residual disease (MRD), Circulating tumour DNA (ctDNA), MRD / molecular residual disease testing, Liquid biopsy (ctDNA).
Shares ctDNA MRD positivity (molecular residual disease after curative treatment), Minimal / molecular residual disease (MRD), Circulating tumour DNA (ctDNA), MRD / molecular residual disease testing.
Shares ctDNA MRD positivity (molecular residual disease after curative treatment), Minimal / molecular residual disease (MRD), Circulating tumour DNA (ctDNA), MRD / molecular residual disease testing.