Sayedeh-Zahra Kazemi-Harikandei, Mohammad-Reza Salmani Jelodar, Gholamreza Roshandel, Seyed Mohammad Tavangar
{"title":"循环DNA标记物在肺恶性肿瘤患者中的预后作用：一项系统回顾和荟萃分析。","authors":"Sayedeh-Zahra Kazemi-Harikandei, Mohammad-Reza Salmani Jelodar, Gholamreza Roshandel, Seyed Mohammad Tavangar","doi":"10.1080/17520363.2025.2548190","DOIUrl":null,"url":null,"abstract":"<p><strong>Aims: </strong>We aimed to explore the prognostic role of circulating DNA-related markers to improve clinical decision-making in patients with lung malignancies.</p><p><strong>Methods: </strong>A systematic search was performed on PubMed, Scopus, and Web of Science.</p><p><strong>Results: </strong>About 133 articles were included, comprising 5750 EGFR-positive, 1583 ALK-positive, and 9657 patients without specified genetic groups. Circulating tumor DNA (ctDNA) response was a significant prognostic marker associated with improved overall survival (OS) (HR = 0.36 [0.27, 0.47], I2 = 0%) and progression-free survival (PFS) (HR = 0.31 [0.18, 0.55], I2 = 67.33%) in advanced non-small cell lung cancer (NSCLC). Meta-analysis of tumor mutational burden (TMB) in the same group demonstrated trends toward poorer survival outcomes for higher TMB -pooled HR of 1.63 (95%-CI: 0.92, 2.88, I2 = 71.23%) for OS and 1.09 (95%-CI: 0.63, 1.89, I2 = 86.66%) for PFS. Finally, meta-analysis in advanced EGFR-positive NSCLC implicated significant prognostic effect of EGFR response positivity on OS and PFS -pooled HR of 0.39 and 0.27, respectively.</p><p><strong>Conclusion: </strong>Circulating DNA markers entailed valuable information in patient prognostication and depicting treatment efficacies in lung cancer. Further studies are needed to decipher more robust criteria for the presently accepted markers - namely ctDNA and EGFR response measures. Additionally, there are several markers - i.e. TMB - that have more exploratory clinical benefits.</p>","PeriodicalId":9182,"journal":{"name":"Biomarkers in medicine","volume":" ","pages":"793-806"},"PeriodicalIF":2.1000,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12416206/pdf/","citationCount":"0","resultStr":"{\"title\":\"The prognostic role of circulating DNA markers in patients with lung malignancies: a systematic review and meta-analysis.\",\"authors\":\"Sayedeh-Zahra Kazemi-Harikandei, Mohammad-Reza Salmani Jelodar, Gholamreza Roshandel, Seyed Mohammad Tavangar\",\"doi\":\"10.1080/17520363.2025.2548190\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Aims: </strong>We aimed to explore the prognostic role of circulating DNA-related markers to improve clinical decision-making in patients with lung malignancies.</p><p><strong>Methods: </strong>A systematic search was performed on PubMed, Scopus, and Web of Science.</p><p><strong>Results: </strong>About 133 articles were included, comprising 5750 EGFR-positive, 1583 ALK-positive, and 9657 patients without specified genetic groups. Circulating tumor DNA (ctDNA) response was a significant prognostic marker associated with improved overall survival (OS) (HR = 0.36 [0.27, 0.47], I2 = 0%) and progression-free survival (PFS) (HR = 0.31 [0.18, 0.55], I2 = 67.33%) in advanced non-small cell lung cancer (NSCLC). Meta-analysis of tumor mutational burden (TMB) in the same group demonstrated trends toward poorer survival outcomes for higher TMB -pooled HR of 1.63 (95%-CI: 0.92, 2.88, I2 = 71.23%) for OS and 1.09 (95%-CI: 0.63, 1.89, I2 = 86.66%) for PFS. Finally, meta-analysis in advanced EGFR-positive NSCLC implicated significant prognostic effect of EGFR response positivity on OS and PFS -pooled HR of 0.39 and 0.27, respectively.</p><p><strong>Conclusion: </strong>Circulating DNA markers entailed valuable information in patient prognostication and depicting treatment efficacies in lung cancer. Further studies are needed to decipher more robust criteria for the presently accepted markers - namely ctDNA and EGFR response measures. 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The prognostic role of circulating DNA markers in patients with lung malignancies: a systematic review and meta-analysis.
Aims: We aimed to explore the prognostic role of circulating DNA-related markers to improve clinical decision-making in patients with lung malignancies.
Methods: A systematic search was performed on PubMed, Scopus, and Web of Science.
Results: About 133 articles were included, comprising 5750 EGFR-positive, 1583 ALK-positive, and 9657 patients without specified genetic groups. Circulating tumor DNA (ctDNA) response was a significant prognostic marker associated with improved overall survival (OS) (HR = 0.36 [0.27, 0.47], I2 = 0%) and progression-free survival (PFS) (HR = 0.31 [0.18, 0.55], I2 = 67.33%) in advanced non-small cell lung cancer (NSCLC). Meta-analysis of tumor mutational burden (TMB) in the same group demonstrated trends toward poorer survival outcomes for higher TMB -pooled HR of 1.63 (95%-CI: 0.92, 2.88, I2 = 71.23%) for OS and 1.09 (95%-CI: 0.63, 1.89, I2 = 86.66%) for PFS. Finally, meta-analysis in advanced EGFR-positive NSCLC implicated significant prognostic effect of EGFR response positivity on OS and PFS -pooled HR of 0.39 and 0.27, respectively.
Conclusion: Circulating DNA markers entailed valuable information in patient prognostication and depicting treatment efficacies in lung cancer. Further studies are needed to decipher more robust criteria for the presently accepted markers - namely ctDNA and EGFR response measures. Additionally, there are several markers - i.e. TMB - that have more exploratory clinical benefits.
期刊介绍：
Biomarkers are physical, functional or biochemical indicators of physiological or disease processes. These key indicators can provide vital information in determining disease prognosis, in predicting of response to therapies, adverse events and drug interactions, and in establishing baseline risk. The explosion of interest in biomarker research is driving the development of new predictive, diagnostic and prognostic products in modern medical practice, and biomarkers are also playing an increasingly important role in the discovery and development of new drugs. For the full utility of biomarkers to be realized, we require greater understanding of disease mechanisms, and the interplay between disease mechanisms, therapeutic interventions and the proposed biomarkers. However, in attempting to evaluate the pros and cons of biomarkers systematically, we are moving into new, challenging territory.
Biomarkers in Medicine (ISSN 1752-0363) is a peer-reviewed, rapid publication journal delivering commentary and analysis on the advances in our understanding of biomarkers and their potential and actual applications in medicine. The journal facilitates translation of our research knowledge into the clinic to increase the effectiveness of medical practice.
As the scientific rationale and regulatory acceptance for biomarkers in medicine and in drug development become more fully established, Biomarkers in Medicine provides the platform for all players in this increasingly vital area to communicate and debate all issues relating to the potential utility and applications.
Each issue includes a diversity of content to provide rounded coverage for the research professional. Articles include Guest Editorials, Interviews, Reviews, Research Articles, Perspectives, Priority Paper Evaluations, Special Reports, Case Reports, Conference Reports and Company Profiles. Review coverage is divided into themed sections according to area of therapeutic utility with some issues including themed sections on an area of topical interest.
Biomarkers in Medicine provides a platform for commentary and debate for all professionals with an interest in the identification of biomarkers, elucidation of their role and formalization and approval of their application in modern medicine. The audience for Biomarkers in Medicine includes academic and industrial researchers, clinicians, pathologists, clinical chemists and regulatory professionals.
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