Utilização de DNA Tumoral Circulante na Análise de Prognóstico de Pacientes com Tumores Malignos Sólidos do Trato Gastrintestinal: Revisão Sistemática
DOI:
https://doi.org/10.32635/2176-9745.RBC.2024v70n4.4873Palavras-chave:
Biópsia líquida/métodos, DNA Tumoral Circulante, Prognóstico, Trato gastrintestinal/patologiaResumo
Introdução: O DNA tumoral circulante (ctDNA), um dos principais expoentes da biópsia líquida, constitui uma ferramenta promissora na área da oncologia. Contudo, seu uso na prática clínica, apesar de variado, necessita de maiores embasamentos. Objetivo: Avaliar o impacto da utilização do DNA tumoral circulante como ferramenta para qualificar o prognóstico de pacientes com tumores malignos sólidos do trato gastrintestinal. Método: Revisão sistemática baseada em estudos do tipo coorte, utilizando as bases de dados MEDLINE, LILACS, SciELO, Science Direct e BASE. A avaliação da qualidade metodológica foi feita pela Newcaslte-Ottawa Quality Assessment Scale. Resultados: Dos 557 artigos encontrados inicialmente, a amostra final do presente estudo contou com 13 artigos. Observou-se maiores taxas de recidiva tumoral e menores taxas de sobrevida em pacientes ctDNA-positivos com tumores de todos os principais sítios do trato gastrintestinal, em relação àqueles ctDNA-negativos. Esta correlação foi consistente ao longo de todos os estágios tumorais. Ademais, o ctDNA se mostrou mais eficaz na predição de recidiva tumoral comprovada por exame radiológico quando comparado ao antígeno carcinoembrionário, tipicamente utilizado nesse contexto. Conclusão: Os resultados encontrados apoiam a utilização do DNA tumoral circulante no cenário descrito, de modo complementar às ferramentas de avaliação de prognóstico comumente utilizadas na prática clínica atual.
Downloads
Referências
American Cancer Society. Global cancer facts & figures. 5. ed. Nova Yorke: ACS; 2024.
Souza T, Migowski A, Ribeiro C, et al. ABC do câncer: abordagens básicas para o controle do câncer. 6 ed rev atual. Rio de Janeiro: INCA; 2020.
Vaidyanathan R, Soon RH, Zhang P, et al. Cancer diagnosis: from tumor to liquid biopsy and beyond. Lab Chip. 2019;19:11-34. doi: https://doi.org/10.1039/c8lc00684a DOI: https://doi.org/10.1039/C8LC00684A
Pessoa LS, Heringer M, Ferrer VP. ctDNA as a cancer biomarker: a broad overview. Crit Rev Oncol Hematol. 2020;155:103109. doi: https://doi.org/10.1016/j.critrevonc.2020.103109 DOI: https://doi.org/10.1016/j.critrevonc.2020.103109
Leso H, Moraes J, Amorim I, et al. Epidemiologia do câncer do trato gastrointestinal em itumbiara, Goiás, entre 1999 e 2019. RSD. 2022;11(15). doi: https://doi.org/10.33448/rsd-v11i15.37540 DOI: https://doi.org/10.33448/rsd-v11i15.37540
Shamseer L, Moher D, Clarke M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation. BMJ. 2015;350:g7647. doi: https://doi.org/10.1136/bmj.g7647 DOI: https://doi.org/10.1136/bmj.g7647
University of York. Centre for Reviews and Dissemination. New York: University of York; 2019. PROSPERO -International prospective register of systematic reviews. 2023. [acesso 2023 ago 31]. Disponível em: https://www.crd.york.ac.uk/PROSPERO/
Ouzzani M, Hammady H, Fedorowicz Z, et al. Rayyan-a web and mobile app for systematic reviews. Syst Rev. 2016;5(1):210. doi: https://doi.org/10.1186/s13643-016-0384-4 DOI: https://doi.org/10.1186/s13643-016-0384-4
Page MJ, McKenzie JE, Bossuyt PM, et al. A declaração PRISMA 2020: diretriz atualizada para relatar revisões sistemáticas. Epidemiol Serv Saúde. 2022;31(2):e2022107. doi: http://dx.doi.org/10.1590/s1679-49742022000200033
Chen G, Peng J, Xiao Q, et al. Postoperative circulating tumor DNA as markers of recurrence risk in stages II to III colorectal cancer. J Hematol Oncol. 2021;14(1):80. doi: https://doi.org/10.1186/s13045-021-01089-z DOI: https://doi.org/10.1186/s13045-021-01089-z
Henriksen TV, Tarazona N, Frydendahl A, et al. Circulating tumor DNA in stage III colorectal cancer, beyond minimal residual disease detection, toward assessment of adjuvant therapy efficacy and clinical behavior of recurrences. Clin Cancer Res. 2022;28(3):507-17. doi: https://doi.org/10.1158/1078-0432.ccr-21-2404 DOI: https://doi.org/10.1158/1078-0432.CCR-21-2404
McDuff SGR, Hardiman KM, Ulintz PJ, et al. Circulating tumor DNA predicts pathologic and clinical outcomes following neoadjuvant chemoradiation and surgery for patients with locally advanced rectal cancer. JCO Precis Oncol. 2021;5:PO.20.00220. doi: https://doi.org/10.1200/po.20.00220 DOI: https://doi.org/10.1200/PO.20.00220
Reinert T, Henriksen TV, Christensen E, et al. Analysis of plasma cell-free DNA by ultradeep sequencing in patients with stages I to III colorectal cancer. JAMA Oncol. 2019;5(8):1124-31. doi: https://doi.org/10.1001/jamaoncol.2019.0528 DOI: https://doi.org/10.1001/jamaoncol.2019.0528
Tie J, Wang Y, Tomasetti C, et al. Circulating tumor DNA analysis detects minimal residual disease and predicts recurrence in patients with stage II colon cancer. Sci Transl Med. 2016;8(346):346ra92. doi: https://doi.org/10.1126/scitranslmed.aaf6219 DOI: https://doi.org/10.1126/scitranslmed.aaf6219
Tie J, Cohen JD, Wang Y, et al. Circulating tumor DNA analyses as markers of recurrence risk and benefit of adjuvant therapy for stage III colon cancer. JAMA Oncol. 2019;5(12):1710-7. doi: https://doi.org/10.1001/jamaoncol.2019.3616 DOI: https://doi.org/10.1001/jamaoncol.2019.3616
Tie J, Cohen JD, Wang Y, et al. Serial circulating tumour DNA analysis during multimodality treatment of locally advanced rectal cancer: a prospective biomarker study. Gut. 2019;68(4):663-71. doi: https://doi.org/10.1136/gutjnl-2017-315852 DOI: https://doi.org/10.1136/gutjnl-2017-315852
Wang Y, Li L, Cohen JD, et al. Prognostic potential of circulating tumor DNA measurement in postoperative surveillance of nonmetastatic colorectal cancer. JAMA Oncol. 2019;5(8):1118-23. doi: https://doi.org/10.1001/jamaoncol.2019.0512 DOI: https://doi.org/10.1001/jamaoncol.2019.0512
Zhou J, Wang C, Lin G, et al. Serial circulating tumor DNA in predicting and monitoring the effect of neoadjuvant chemoradiotherapy in patients with rectal cancer: a prospective multicenter study. Clin Cancer Res. 2021;27(1):301-10. doi: https://doi.org/10.1158/1078-0432.ccr-20-2299 DOI: https://doi.org/10.1158/1078-0432.CCR-20-2299
Huffman BM, Aushev VN, Budde GL, et al. Analysis of circulating tumor DNA to predict risk of recurrence in patients with esophageal and gastric cancers. JCO Precis Oncol. 2022;(6):e2200420. doi: https://doi.org/10.1200/po.22.00420 DOI: https://doi.org/10.1200/PO.22.00420
Zhang M, Yang H, Fu T, et al. Liquid biopsy: circulating tumor DNA monitors neoadjuvant chemotherapy response and prognosis in stage II/III gastric cancer. Mol Oncol. 2023;17(9):1930-42. doi: https://doi.org/10.1002/1878-0261.13481 DOI: https://doi.org/10.1002/1878-0261.13481
Li Y, Mo S, Zhang L, et al. Postoperative circulating tumor DNA combined with consensus molecular subtypes can better predict outcomes in stage III colon cancers: a prospective cohort study. Eur J Cancer. 2022;169:198-
doi: https://doi.org/10.1016/j.ejca.2022.04.010 DOI: https://doi.org/10.1016/j.ejca.2022.04.010
Pazdirek F, Minarik M, Benesova L, et al. Monitoring of early changes of circulating tumor dna in the plasma of rectal cancer patients receiving neoadjuvant concomitant chemoradiotherapy: evaluation for prognosis and prediction of therapeutic response. Front Oncol. 2020;10:1028. doi: https://doi.org/10.3389/fonc.2020.01028 DOI: https://doi.org/10.3389/fonc.2020.01028
Peng Y, Mei W, Ma K, et al. Circulating tumor DNA and minimal residual disease (MRD) in solid tumors: current horizons and future perspectives. Front Oncol. 2021;11:763790. doi: https://doi.org/10.3389/fonc.2021.763790 DOI: https://doi.org/10.3389/fonc.2021.763790
Ueberroth BE, Jones JC, Bekaii-Saab TS. Circulating tumor DNA (ctDNA) to evaluate minimal residual disease (MRD), treatment response, and posttreatment prognosis in pancreatic adenocarcinoma. Pancreatology. 2022;22(6):741-8. doi: https://doi.org/10.1016/j. pan.2022.06.009 DOI: https://doi.org/10.1016/j.pan.2022.06.009
Jiang M, Zhou H, Jiang S, et al. A review of circulating tumor DNA in the diagnosis and monitoring of esophageal cancer. Med Sci Monit. 2022;28:e934106. doi: https://doi.org/10.12659/msm.934106 DOI: https://doi.org/10.12659/MSM.934106
Gao Y, Zhang K, Xi H, et al. Diagnostic and prognostic value of circulating tumor DNA in gastric cancer: a meta-analysis. Oncotarget. 2016;8(4):6330-40. doi: https://doi.org/10.18632/oncotarget.14064 DOI: https://doi.org/10.18632/oncotarget.14064
Fan G, Zhang K, Yang X, et al. Prognostic value of circulating tumor DNA in patients with colon cancer: systematic review. PLoS One. 2017;12(2):e0171991. doi: https://doi.org/10.1371/journal.pone.0171991 DOI: https://doi.org/10.1371/journal.pone.0171991
Cimmino F, Lasorsa VA, Vetrella S, et al. A targeted gene panel for circulating tumor DNA sequencing in neuroblastoma. Front Oncol. 2020;10:596191. doi: https://doi.org/10.3389/fonc.2020.596191 DOI: https://doi.org/10.3389/fonc.2020.596191
Lim Y, Kim S, Kang JK, et al. Circulating tumor DNA sequencing in colorectal cancer patients treated with first-line chemotherapy with anti-EGFR. Sci Rep. 2021;11:16333. doi: https://doi.org/10.1038/s41598-021-95345-4 DOI: https://doi.org/10.1038/s41598-021-95345-4
Chen Y, Mo S, Wu M, et al. Circulating tumor DNA as a prognostic indicator of colorectal cancer recurrence -a systematic review and meta-analysis. Int J Colorectal Dis. 2022;37(5):1021-7. doi: https://doi.org/10.1007/s00384-022-04144-4 DOI: https://doi.org/10.1007/s00384-022-04144-4
Cheng ML, Lau CJ, Milan MSD, et al. Plasma ctDNA response is an early marker of treatment effect in advanced NSCLC. JCO Precis Oncol. 2021;5:PO.20.00419. doi: https://doi.org/10.1200/po.20.00419 DOI: https://doi.org/10.1200/PO.20.00419
Sharbatoghli M, Vafaei S, Aboulkheyr ESH, et al. Prediction of the treatment response in ovarian cancer: a ctDNA approach. J Ovarian Res. 2020;13(1):124. doi: https://doi.org/10.1186/s13048-020-00729-1 DOI: https://doi.org/10.1186/s13048-020-00729-1
Massihnia D, Pizzutilo EG, Amatu A, et al. Liquid biopsy for rectal cancer: a systematic review. Cancer Treat Rev. 2019;79:101893. doi: https://doi.org/10.1016/j.ctrv.2019.101893 DOI: https://doi.org/10.1016/j.ctrv.2019.101893
Downloads
Publicado
Como Citar
Edição
Seção
Licença
Os direitos morais e intelectuais dos artigos pertencem aos respectivos autores, que concedem à RBC o direito de publicação.
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
