|Publication Type||Journal Article|
|Year of Publication||2018|
|Authors||Choudhury, AD, Werner, L, Francini, E, Wei, XX, Ha, G, Freeman, SS, Rhoades, J, Reed, SC, Gydush, G, Rotem, D, Lo, C, Taplin, M-E, Harshman, LC, Zhang, Z, O'Connor, EP, Stover, DG, Parsons, HA, Getz, G, Meyerson, M, J Love, C, Hahn, WC, Adalsteinsson, VA|
|Date Published||2018 Nov 02|
BACKGROUND: Tumor content in circulating cell-free DNA (cfDNA) is a promising biomarker, but longitudinal dynamics of tumor-derived and non-tumor-derived cfDNA through multiple courses of therapy have not been well described.
METHODS: CfDNA from 663 plasma samples from 140 patients with castration-resistant prostate cancer (CRPC) was subject to sparse whole genome sequencing. Tumor fraction (TFx) estimated using the computational tool ichorCNA was correlated with clinical features and responses to therapy.
RESULTS: TFx associated with the number of bone metastases (median TFx = 0.014 with no bone metastases, 0.047 with 1-3 bone metastases, 0.190 for 4+ bone metastases; P < 0.0001) and with visceral metastases (P < 0.0001). In multivariable analysis, TFx remained associated with metastasis location (P = 0.042); TFx was positively correlated with alkaline phosphatase (P = 0.0227) and negatively correlated with hemoglobin (Hgb) (P < 0.001), but it was not correlated with prostate specific antigen (PSA) (P = 0.75). Tumor-derived and non-tumor-derived cfDNA track together and do not increase with generalized tissue damage from chemotherapy or radiation at the time scales examined. All new treatments that led to ≥30% PSA decline at 6 weeks were associated with TFx decline when baseline TFx was >7%; however, TFx in patients being subsequently maintained on secondary hormonal therapy was quite dynamic.
CONCLUSION: TFx correlates with clinical features associated with overall survival in CRPC, and TFx decline is a promising biomarker for initial therapeutic response.
TRIAL REGISTRATION: Dana-Farber/Harvard Cancer Center (DF/HCC) protocol no. 18-135.
FUNDING: Wong Family Award in Translational Oncology, Dana Farber Cancer Institute Medical Oncology grant, Gerstner Family Foundation, Janssen Pharmaceuticals Inc., and Koch Institute Support (core) grant P30-CA14051 from the National Cancer Institute (NCI).
|Alternate Journal||JCI Insight|