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- Title
Detection of minimal residual disease using circulating tumor DNA in patients treated with long-term PARP inhibitors maintenance for epithelial ovarian cancer.
- Authors
Jung-Yun Lee; Dahye Lee; Yoo-Na Kim; DongJu Won; Saeam Shin; Sang Wun Kim
- Abstract
Objective: This study aimed to address the challenge of determining the endpoint for maintenance therapy with poly (ADP-ribose) polymerase inhibitors (PARPi) in epithelial ovarian cancer (EOC) by monitoring minimal residual disease (MRD) using circulating tumor DNA (ctDNA). Methods: A prospective observational study was conducted at a single center, involving 27 patients with EOC who underwent PARPi as maintenance therapy for at least two years. Whole blood samples were collected, and ctDNA was enriched using a custom panel targeting nine ovarian cancer-related genes (Dxome). Sequencing with NovaSeq 6000 System (Illumina) and analysis with PiSeq algorighm (Dxome) were performed to assess post-treatment MRD correlated with personalized tumor nextgeneration sequencing (NGS) results. Surveillance for relapse included radiologic features from computed tomography and CA-125 levels. Results: Of the 27 patients, most had advanced-stage disease (92.6%) and high-grade serous histology (100%). PARPi was administered as front-line maintenance in 40.7% and beyond the first line in 59.3%. Two patients (7.4%) were MRD positive, with one showing a concordant ctDNA-based mutation and another acquiring a new mutation. During a median monitoring duration of 10 months, 12.5% experienced disease progression among the MRD-negative patients. Conclusion: ctDNA emerges as a potential biomarker for MRD monitoring in EOC patients undergoing PARPi maintenance therapy. The detection of MRD-positive cases highlights the importance of vigilant monitoring for potential relapse. ctDNA could aid in deciding whether to continue or discontinue PARPi maintenance therapy. Further research is crucial to validate the effectiveness of ctDNA in this context.
- Subjects
CIRCULATING tumor DNA; OVARIAN epithelial cancer; POLY(ADP-ribose) polymerase; COMPUTED tomography; CELL-free DNA
- Publication
Journal of Gynecologic Oncology, 2024, Vol 35, p22
- ISSN
2005-0380
- Publication type
Academic Journal
- DOI
10.3802/jgo.2024.35.S2.P4