Objective: Assessing plasma Cell Free DNA (cfDNA) integrity index as a biomarker for response prediction and early response evaluation in mCRC patients receiving chemotherapy, in comparison to Carcinoembryonic antigen (CEA) and Carbohydrate antigen 19-9 (CA19-9), to be used as an additional tool to computed tomography (CT). Methods: CEA, CA19-9, cfDNA concentration and cfDNA integrity index (ALU 247/115) measurements were conducted on 86 subjects divided into 43 healthy volunteers and 43 mCRC patients, before starting chemotherapy and then after 6-12 weeks of therapy initiation (3-4 cycles FOLFOX) at first response assessment. Plasma cfDNA integrity index was calculated as the ratio of long to short DNA fragments (ALU 247/115) amplified and detected by real-time PCR. Serum CEA and CA19-9 were measured by chemiluminescent immunometric assay. Results: Baseline cfDNA integrity index was statistically significantly different between responders and non-responders (p=0.03). It was found that at cut off 0.608, sensitivity was 73.7%, specificity was 66.7% and diagnostic accuracy=69.77%. Markers with statistical significant difference between responders and non-responders after chemotherapy were CEA % change (p=0.035), CA19-9 (p=0.024), cfDNA integrity index (p=0.035) and cfDNA integrity index % change (p<0.001). Among these markers, cfDNA integrity index % change had the best sensitivity (84.2%), specificity (95.2%) and diagnostic accuracy (90.7%) at cut off -17.827%. Conclusion: Baseline cfDNA integrity index can be used as a potential marker to predict response to chemotherapy. cfDNA integrity index (ALU 247/115) % change rather than its absolute value is superior to CEA, CA19-9, cfDNA concentration and their % changes in early assessment of response to chemotherapy.
Eskander, N., Mansour, L., Abdelaal, A., Saad, E., & Mohamed, D. (2022). Circulating Cell Free DNA Integrity Index as a Biomarker for Response to Chemotherapy in Patients with Metastatic Colorectal Carcinoma. Asian Pacific Journal of Cancer Prevention, 23(1), 339-348. doi: 10.31557/APJCP.2022.23.1.339
MLA
Nancy Samir Eskander; Lamia Mansour; Amaal Abdelaal; Ehab Saad; Doaa Mohamed. "Circulating Cell Free DNA Integrity Index as a Biomarker for Response to Chemotherapy in Patients with Metastatic Colorectal Carcinoma". Asian Pacific Journal of Cancer Prevention, 23, 1, 2022, 339-348. doi: 10.31557/APJCP.2022.23.1.339
HARVARD
Eskander, N., Mansour, L., Abdelaal, A., Saad, E., Mohamed, D. (2022). 'Circulating Cell Free DNA Integrity Index as a Biomarker for Response to Chemotherapy in Patients with Metastatic Colorectal Carcinoma', Asian Pacific Journal of Cancer Prevention, 23(1), pp. 339-348. doi: 10.31557/APJCP.2022.23.1.339
VANCOUVER
Eskander, N., Mansour, L., Abdelaal, A., Saad, E., Mohamed, D. Circulating Cell Free DNA Integrity Index as a Biomarker for Response to Chemotherapy in Patients with Metastatic Colorectal Carcinoma. Asian Pacific Journal of Cancer Prevention, 2022; 23(1): 339-348. doi: 10.31557/APJCP.2022.23.1.339
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