NPY Gene Methylation as a Universal, Longitudinal Plasma Marker for Evaluating the Clinical Benefit from Last-Line Treatment with Regorafenib in Metastatic Colorectal Cancer
Abstract
:1. Introduction
2. Results
2.1. Patient Characteristics
2.2. Treatment
2.3. Toxicity
2.4. Efficacy of Regorafenib
2.5. Tumor Specific DNA
2.6. Dynamics of ctDNA
3. Discussion
4. Materials and Methods
4.1. Patients
4.2. Ethics and Approvals
4.3. Trial Design and Treatment
4.4. Evaluations
4.5. Blood Samples and Tumor Tissue
4.5.1. DNA Purification
4.5.2. Quantification of Total Plasma DNA
4.5.3. Concentration
4.5.4. RAS/RAF Mutation Analysis
4.5.5. Methylation Analysis
4.6. Statistics
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Characteristic | Categories | Data |
---|---|---|
Age | Median (min–max), years | 65 (28–77) |
Time since first chemotherapy for metastatic colorectal cancer | Median (min–max), years | 1.8 (0.4–10.9) |
n | ||
Sex | Female | 47 |
Male | 53 | |
Localization of primary tumor | Right colon | 30 |
Left colon | 31 | |
Rectum | 35 | |
NR | 4 | |
No of metastatic sites | 1–2 | 54 |
2+ | 46 | |
Performance status | 0 | 43 |
1 | 54 | |
NR | 3 | |
Treatment, adjuvant | Fluoropyrimidine monotherapy | 36 |
Fluoropyrimidine and oxaliplatin | 30 | |
Treatment, metastatic | Fluoropyrimidine | 96 |
Oxaliplatin | 87 | |
Irinotecan | 98 | |
Bevacizumab | 90 | |
EGFR inhibitor | 33 | |
Other | 5 | |
NR | 2 | |
Mutation in tumor tissue | KRAS | 51 |
NRAS | 4 | |
BRAF | 6 | |
Wild-type or NR | 39 |
Adverse Event | Grade 1–2 N (%) | Grade 3–4 N (%) |
---|---|---|
Hypertension | 31 (33%) | 8 (8%) |
Hand-foot-skin reaction | 48 (51%) | 6 (6%) |
Rash | 20 (21%) | 6 (6%) |
Fatigue | 77 (81%) | 4 (4%) |
Diarrhea | 35 (37%) | 3 (3%) |
Anorexia | 60 (63%) | 2 (2%) |
Oral mucositis | 43 (45%) | 2 (2%) |
Nausea | 35 (37%) | 1 (1%) |
Voice changes | 66 (69%) | 0 (0%) |
Conjunctivitis | 19 (20%) | 0 (0%) |
Bleeding | 16 (17%) | 0 (0%) |
Other toxicites | 65 (68%) | 19 (20%) |
Endpoint | Categories | N | Data | 95% CI |
---|---|---|---|---|
Response rate | Stable disease | 45 | 60% | 48–71% |
Progressive disease | 30 | 40% | 29–52% | |
PFS | At 2 months | 46 | 46% | 36–56% |
Median | 100 | 2.1 months | 1.8–3.4 | |
OS | Median | 100 | 5.2 months | 4.3–6.5 |
Characteristic | Categories | Clinical Trial, n | Mut ctDNA | Meth ctDNA | ||||
---|---|---|---|---|---|---|---|---|
n | Mean % (95%CI) | p-Value | n | Mean % (95%CI) | p-Value | |||
Age | Median (min–max), years 65 (28–77) | 100 | 46 | 25 (19–32) | 0.19 | 82 | 25 (20–30) | 0.24 |
Sex | Female | 47 | 21 | 25 (14–36) | 40 | 21 (14–27) | ||
Male | 53 | 25 | 25 (18–33) | 0.77 | 41 | 30 (22–37) | 0.11 | |
Localization of primary tumor | Right colon | 30 | 18 | 26 (16–37) | 24 | 30 (19–44) | ||
Left colon | 31 | 14 | 27 (12–41) | 24 | 21 (10–31) | |||
Rectum | 35 | 13 | 23 (12–35) | 0.98 | 31 | 23 (17–30) | 0.32 | |
Performance status | 0 | 43 | 22 | 24 (15–33) | 34 | 21 (15–30) | ||
1 | 54 | 24 | 27 (17–36) | 0.96 | 46 | 27 (19–34) | 0.58 |
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Jensen, L.H.; Olesen, R.; Petersen, L.N.; Boysen, A.K.; Andersen, R.F.; Lindebjerg, J.; Nottelmann, L.; Thomsen, C.E.B.; Havelund, B.M.; Jakobsen, A.; et al. NPY Gene Methylation as a Universal, Longitudinal Plasma Marker for Evaluating the Clinical Benefit from Last-Line Treatment with Regorafenib in Metastatic Colorectal Cancer. Cancers 2019, 11, 1649. https://doi.org/10.3390/cancers11111649
Jensen LH, Olesen R, Petersen LN, Boysen AK, Andersen RF, Lindebjerg J, Nottelmann L, Thomsen CEB, Havelund BM, Jakobsen A, et al. NPY Gene Methylation as a Universal, Longitudinal Plasma Marker for Evaluating the Clinical Benefit from Last-Line Treatment with Regorafenib in Metastatic Colorectal Cancer. Cancers. 2019; 11(11):1649. https://doi.org/10.3390/cancers11111649
Chicago/Turabian StyleJensen, Lars Henrik, René Olesen, Lone Noergaard Petersen, Anders Kindberg Boysen, Rikke Fredslund Andersen, Jan Lindebjerg, Lise Nottelmann, Caroline Emilie Brenner Thomsen, Birgitte Mayland Havelund, Anders Jakobsen, and et al. 2019. "NPY Gene Methylation as a Universal, Longitudinal Plasma Marker for Evaluating the Clinical Benefit from Last-Line Treatment with Regorafenib in Metastatic Colorectal Cancer" Cancers 11, no. 11: 1649. https://doi.org/10.3390/cancers11111649