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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 9/2011

01-09-2011 | Colorectal Cancer

Circulating Cell-Free DNA: A Promising Marker of Pathologic Tumor Response in Rectal Cancer Patients Receiving Preoperative Chemoradiotherapy

Authors: Marco Agostini, PhD, Salvatore Pucciarelli, MD, Maria Vittoria Enzo, PhD, Paola Del Bianco, PhD, Marta Briarava, PhD, Chiara Bedin, PhD, Isacco Maretto, MD, Maria Luisa Friso, MD, Sara Lonardi, MD, Claudia Mescoli, MD, Paola Toppan, MD, Emanuele Urso, MD, PhD, Donato Nitti, MD

Published in: Annals of Surgical Oncology | Issue 9/2011

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Abstract

Purpose

The circulating cell-free DNA (cfDNA) in plasma has been reported to be a marker of cancer detection. The aim of this study was to investigate whether the cfDNA has a role as response biomarker in patients receiving preoperative chemoradiotherapy (CRT) for rectal cancer.

Methods

Sixty-seven patients (median age 61 years; male/female 42/25) who underwent CRT for rectal cancer were evaluated. After tumor regression grade (TRG) classification was made, the patients were classified as having disease that responded (TRG 1–2) and that did not respond (TRG 3–5) to therapy. Plasma samples were obtained from patients before and after CRT. The cfDNA levels were analyzed by quantitative real-time polymerase chain reaction of β-globin. On the basis of the Alu repeats, the cfDNA was considered as either total (fragments of 115 bp, Alu 115) or tumoral (fragments of 247 bp, Alu 247). The association between the pre- or post-CRT levels and between variations during CRT of the Alu 247, Alu 115 repeat, and Alu 247/115 ratio (cfDNA integrity index) and the pathologic tumor response was analyzed.

Results

The baseline levels of cfDNA were not associated with tumor response. The post-CRT levels of the cfDNA integrity index were significantly lower in responsive compared to nonresponsive disease (P = 0.0009). Both the median value of the Alu 247 repeat and the cfDNA integrity index decreased after CRT in disease that responded to therapy (P < 0.005 and P < 0.005, respectively) compared to disease that did not respond to therapy (P = 0.83 and P = 0.726, respectively). The results of the multivariable logistic regression analysis showed that only the cfDNA integrity index was significantly and independently associated with tumor response to treatment.

Conclusions

The plasma levels of the longer fragments (Alu 247) of cfDNA and the cfDNA integrity index are promising markers to predict tumor response after preoperative CRT for rectal cancer.
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Metadata
Title
Circulating Cell-Free DNA: A Promising Marker of Pathologic Tumor Response in Rectal Cancer Patients Receiving Preoperative Chemoradiotherapy
Authors
Marco Agostini, PhD
Salvatore Pucciarelli, MD
Maria Vittoria Enzo, PhD
Paola Del Bianco, PhD
Marta Briarava, PhD
Chiara Bedin, PhD
Isacco Maretto, MD
Maria Luisa Friso, MD
Sara Lonardi, MD
Claudia Mescoli, MD
Paola Toppan, MD
Emanuele Urso, MD, PhD
Donato Nitti, MD
Publication date
01-09-2011
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 9/2011
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-011-1638-y

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