Quantification of free plasma DNA before and after chemotherapy in patients with advanced epithelial ovarian cancer.
OBJECTIVE
A nonrandomized trial was planned to investigate the role of free plasma DNA (FPDNA) in patients with epithelial ovarian cancer before and after chemotherapy. Twenty-two patients with advanced stage ovarian cancer not suitable for debulking were treated with a neoadjuvant platinum/taxanes chemotherapy. Patients with clinical complete or partial response underwent radical hystero-oophorectomy, omentectomy, and lymphadenectomy and were followed up every 3 to 6 months.


METHODS
Blood samples were obtained from each patient before chemotherapy, before each cycle, before and after surgery. FPDNA was quantified by real-time quantitative polymerase chain reaction using the Quantifiler Human Quantification Kit and expressed in ng/mL. Fifty female healthy blood donor volunteers were used as controls.


RESULTS
Median FPDNA quantities discriminated between patients before chemotherapy (29.6+/-22.7 ng/mL) and controls (6.4+/-4.0 ng/mL) using a 14.5 ng/mL cutoff with 77% sensitivity and 96% specificity (P<0.001). Mean FPDNA concentrations significantly decreased after chemotherapy (17.9+/-14.5 ng/mL, P=0.001). A peak of FPDNA levels (66.2+/-45.2 ng/mL) was observed in association with surgery (P<0.001). Median follow-up and median progression-free survival time were 13.4+/-5.1 and 11.7+/-5.6 months, respectively. Eight patients with FPDNA values above the cutoff after chemotherapy showed disease progression or died, whereas 7 patients with FPDNA below the cutoff were free from disease. Patients with FPDNA levels above and below the cutoff showed significantly separated progression-free survival curves (P=0.007, log-rank test).


CONCLUSIONS
FPDNA quantification significantly discriminates between cancer patients and controls and correlates with response to chemotherapy. Although performed in a limited series, we demonstrated a correlation between FPDNA values and clinical behavior of ovarian cancer patients.
Capizzi
Elisa
E
Molecular Pathology Laboratory, Addarii Institute of Oncology, University of Bologna, Bologna, Italy.
Gabusi
Elena
E
Grigioni
Antonia D'Errico
AD
De Iaco
Pierandrea
P
Rosati
Marta
M
Zamagni
Claudio
C
Fiorentino
Michelangelo
M
D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D018394:CA-125 Antigen / Q000032:analysis; D016190:Carboplatin / Q000008:administration & dosage; D004273:DNA, Neoplasm / Q000097:blood*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009375:Neoplasms, Glandular and Epithelial / Q000097:blood* / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D010051:Ovarian Neoplasms / Q000097:blood* / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D010052:Ovariectomy; D017239:Paclitaxel / Q000008:administration & dosage; D016019:Survival Analysis; D016896:Treatment Outcome
D018394:CA-125 Antigen; D004273:DNA, Neoplasm; D016190:Carboplatin; D017239:Paclitaxel