Journal article
Peritoneal Cell-Free Tumor DNA is a Biomarker of Locoregional and Peritoneal Recurrence in Resected Pancreatic Ductal Adenocarcinomas
Annals of surgical oncology, Vol.30(11), pp.6652-6660
10/2023
DOI: 10.1245/s10434-023-13701-2
PMID: 37303025
Abstract
BACKGROUND Recurrence after curative-intent pancreatectomy for pancreatic ductal adenocarcinomas (PDAC) is quite frequent with locoregional and peritoneal recurrence in about one-third of cases. We hypothesize that peritoneal cell-free tumor DNA (ptDNA) present in the intraoperative peritoneal lavage (PL) fluid may be used as a predictive biomarker of locoregional and peritoneal recurrence. PATIENTS AND METHODS Under institutional review board (IRB)-approved protocol, pre- and postresection PL fluids were collected from PDAC patients undergoing curative-intent pancreatectomy. PL fluids from PDAC patients with pathologically proven peritoneal metastasis were also collected as positive controls. Cell-free DNA was extracted from PL fluids. Droplet digital PCR (ddPCR) was performed using ddPCR KRAS G12/G13 screening kit. Recurrence-free survival (RFS) based on KRAS-mutant ptDNA level was determined using Kaplan-Meier methods. RESULTS KRAS-mutant ptDNA was detected in PL fluids from all PDAC patients. KRAS-mutant ptDNA was detected in 11/21 (52%) preresection and 15/18 (83%) postresection PL fluid samples. With a median follow-up of 23.6 months, 12 patients developed recurrence (8 locoregional/peritoneal recurrence, 9 pulmonary/hepatic recurrence); 5/8 (63%) and 6/6 (100%) patients with mutant allele frequency (MAF) of > 0.10% in pre- and postresection PL fluids, respectively, developed recurrence. Using a cutoff value of 0.10% MAF, the presence of KRAS-mutant ptDNA in postresection PL fluid predicted a significantly shortened time to locoregional and peritoneal recurrence (median RFS of 8.9 months versus not reached, P = 0.003). CONCLUSIONS This study suggests that ptDNA in postresection PL fluids may be a useful biomarker to predict locoregional and peritoneal recurrence in resected PDAC patients.
Details
- Title: Subtitle
- Peritoneal Cell-Free Tumor DNA is a Biomarker of Locoregional and Peritoneal Recurrence in Resected Pancreatic Ductal Adenocarcinomas
- Creators
- Katie M Leick - University of Iowa Hospitals and ClinicsAnn Tomanek-Chalkley - University of IowaKristen L Coleman - University of IowaCarlos H F Chan - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Annals of surgical oncology, Vol.30(11), pp.6652-6660
- DOI
- 10.1245/s10434-023-13701-2
- PMID
- 37303025
- eISSN
- 1534-4681
- Grant note
- DOI: 10.13039/100000054, name: National Cancer Institute, award: P30CA086862
- Language
- English
- Electronic publication date
- 06/11/2023
- Date published
- 10/2023
- Academic Unit
- Surgery; Radiation Oncology; Holden Comprehensive Cancer Center
- Record Identifier
- 9984435145202771
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