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A meta-analysis of circulating tumor DNA as a survival indicator in small cell lung cancer patients

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Abstract

A high level of circulating tumor DNA (ctDNA) has been linked to poor survival in patients with certain solid tumors. In spite of this, it is still unclear whether ctDNA is associated with poor survival in small cell lung cancer (SCLC). To investigate the above association, we conducted a systematic review and meta-analysis. PubMed, Web of Science, Cochrane’s Library, and Embase were searched for relevant cohort studies from the inception of the databases to November 28, 2022. Data collection, literature search, and statistical analysis were carried out independently by two authors. To account for heterogeneity, we used a random-effects model. In this meta-analysis, 391 patients with SCLC were identified, and the data were pooled from nine observational studies and followed for 11.4 to 25.0 months. A high ctDNA was associated with worse overall survival (OS, risk ratio [RR] 2.50, 95% confidence interval [CI]1.85 to 3.38, p < 0.001; I2 = 25%) and progression-free survival (PFS, RR 2.33, 95% CI 1.48 to 3.64, p < 0.001, I2 = 42%). Subgroup analyses retrieved consistent results in prospective and retrospective studies, in studies with ctDNA measured with polymerase chain reaction or next-generation sequencing, and in studies analyzed with univariate or multivariate regression models. Studies suggest that ctDNA may be an important factor in predicting poor OS and PFS in SCLC patients.

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Data availability

The original contributions presented in the study are included in the article; further inquiries can be directed to the corresponding author.

Abbreviations

SCLC:

Small cell lung cancer

NSCLC:

Non-small cell lung cancer

ctDNA:

Circulating tumor DNA

OS:

Overall survival

PFS:

Progression-free survival

NOS:

Newcastle–Ottawa Scale

RRs:

Risk ratios

Cis:

Confidence intervals

SEs:

Standard errors

PCR:

Polymerase chain reaction

NGS:

Next-generation sequencing

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Authors and Affiliations

  1. Department of Pathology, The First Medical Center of Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing, 100853, China

    Jie Li, Liqun Wang, Zhouhuan Dong & Zhanbo Wang

  2. Department of Oncology, The First Medical Center of Chinese PLA General Hospital, Beijing, 100853, China

    Qi Song

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Contributions

JL contributed to conceptualization; data curation; formal analysis; and writing-original draft. LW contributed to data curation and formal analysis. ZD contributed to validation; visualization; writing-original draft. QS contributed to data curation and formal analysis. ZW contributed to methodology; supervision; and writing-review and editing. All authors read and approved the final version of the manuscript.

Corresponding author

Correspondence to Zhanbo Wang.

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10238_2023_1052_MOESM1_ESM.pdf

Fig. S1 Sensitivity analysis for the association between ctDNA and PFS of SCLC limited to studies with ctDNA measured with NGS (PDF 152 kb)

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Li, J., Wang, L., Dong, Z. et al. A meta-analysis of circulating tumor DNA as a survival indicator in small cell lung cancer patients. Clin Exp Med 23, 3935–3945 (2023). https://doi.org/10.1007/s10238-023-01052-x

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