北京大学人民医院Jun Wang和广州燃石医学Zhihong Zhang研究组合作，通过对个体肿瘤中的循环肿瘤DNA（ctDNA）进行分析实现了非小细胞肺癌的术后监测。这一研究成果于2023年9月7号发表在国际学术期刊《癌细胞》上。

研究人员研发了一种个性化肿瘤检测技术-患者特异性pROgnostic和潜在治疗标志物跟踪（PROPHET），通过对50个患者特异性变异进行深度测序以检测分子残留病（MRD），其检测限为0.004。对来自181名前瞻性招募的早期非小细胞肺癌患者的760个血浆样本进行了PROPHET和最先进的固定面板测定。PROPHET在基线水平对循环肿瘤DNA具有高45%的灵敏度。

它在预后分析方面优于固定面板测定，并且比放射学确认复发的中位时间提前了299天。非典型个性化变体占98.2%，其预后效果与典型变体相似。研究提出的肿瘤-淋巴结-转移-血液（TNMB）分类在辅助治疗决策点的预后预测方面超过了TNM分期。PROPHET显示出评估辅助治疗效果的潜力，并可为模糊的放射学诊断提供决策。这些发现突出了个性化癌症技术在MRD检测中的潜在优势。

附：英文原文

Title: Individualized tumor-informed circulating tumor DNA analysis for postoperative monitoring of non-small cell lung cancer

Author: Kezhong Chen, Fan Yang, Haifeng Shen, Chenyang Wang, Xi Li, Olga Chervova, Shuailai Wu, Fujun Qiu, Di Peng, Xin Zhu, Shannon Chuai, Stephan Beck, Nnennaya Kanu, David Carbone, Zhihong Zhang, Jun Wang

Issue&Volume:

Abstract: We report a personalized tumor-informed technology, Patient-specific pROgnostic andPotential tHErapeutic marker Tracking (PROPHET) using deep sequencing of 50 patient-specificvariants to detect molecular residual disease (MRD) with a limit of detection of 0.004%.PROPHET and state-of-the-art fixed-panel assays were applied to 760 plasma samplesfrom 181 prospectively enrolled early stage non-small cell lung cancer patients. PROPHETshows higher sensitivity of 45% at baseline with circulating tumor DNA (ctDNA). Itoutperforms fixed-panel assays in prognostic analysis and demonstrates a median lead-timeof 299 days to radiologically confirmed recurrence. Personalized non-canonical variantsaccount for 98.2% with prognostic effects similar to canonical variants. The proposedtumor-node-metastasis-blood (TNMB) classification surpasses TNM staging for prognosticprediction at the decision point of adjuvant treatment. PROPHET shows potential toevaluate the effect of adjuvant therapy and serve as an arbiter of the equivocal radiologicaldiagnosis. These findings highlight the potential advantages of personalized cancertechniques in MRD detection.

DOI: 10.1016/j.ccell.2023.08.010

Source: https://www.cell.com/cancer-cell/fulltext/S1535-6108(23)00286-6