TY  - JOUR
AU  - Milin-Lazović, Jelena
AU  - Madžarević, Petar
AU  - Rajović, Nina
AU  - Đorđević, Vladimir
AU  - Milić, Nikola
AU  - Pavlović, Sonja
AU  - Veljković, Nevena V.
AU  - Milić, Nataša M.
AU  - Radenković, Dejan
PY  - 2021
UR  - https://vinar.vin.bg.ac.rs/handle/123456789/9861
AB  - Introduction: The analysis of cell-free DNA (cfDNA) for genetic abnormalities is a promising new approach for the diagnosis and prognosis of pancreatic cancer patients. Insights into the molecular characteristics of pancreatic cancer may provide valuable information, leading to its earlier detection and the development of targeted therapies. Material and Methods: We conducted a systematic review and a meta-analysis of studies that reported cfDNA in pancreatic ductal adenocarcinoma (PDAC). The studies were considered eligible if they included patients with PDAC, if they had blood tests for cfDNA/ctDNA, and if they analyzed the prognostic value of cfDNA/ctDNA for patients’ survival. The studies published before 22 October 2020 were identified through the PubMED, EMBASE, Web of Science and Cochrane Library databases. The assessed outcomes were the overall (OS) and progression-free survival (PFS), expressed as the log hazard ratio (HR) and standard error (SE). The summary of the HR effect size was estimated by pooling the individual trial results using the Review Manager, version 5.3, Cochrane Collaboration. The heterogeneity was assessed using the Cochran Q test and I2 statistic. Results: In total, 48 studies were included in the qualitative review, while 44 were assessed in the quantitative synthesis, with the total number of patients included being 3524. Overall negative impacts of cfDNA and KRAS mutations on OS and PFS in PDAC (HR = 2.42, 95% CI: 1.95–2.99 and HR = 2.46, 95% CI: 2.01–3.00, respectively) were found. The subgroup analysis of the locally advanced and metastatic disease presented similar results (HR = 2.51, 95% CI: 1.90–3.31). In the studies assessing the pre-treatment presence of KRAS, there was a moderate to high degree of heterogeneity (I2 = 87% and I2 = 48%, for OS and PFS, respectively), which was remarkably decreased in the analysis of the studies measuring post-treatment KRAS (I2 = 24% and I2 = 0%, for OS and PFS, respectively). The patients who were KRAS positive before but KRAS negative after treatment had a better prognosis than the persistently KRAS-positive patients (HR = 5.30, 95% CI: 1.02–27.63). Conclusion: The assessment of KRAS mutation by liquid biopsy can be considered as an additional tool for the estimation of the disease course and outcome in PDAC patients.
T2  - Cancers
T1  - Meta-analysis of circulating cell-free dna’s role in the prognosis of pancreatic cancer
VL  - 13
IS  - 14
SP  - 3378
DO  - 10.3390/cancers13143378
ER  - 

@article{
author = "Milin-Lazović, Jelena and Madžarević, Petar and Rajović, Nina and Đorđević, Vladimir and Milić, Nikola and Pavlović, Sonja and Veljković, Nevena V. and Milić, Nataša M. and Radenković, Dejan",
year = "2021",
abstract = "Introduction: The analysis of cell-free DNA (cfDNA) for genetic abnormalities is a promising new approach for the diagnosis and prognosis of pancreatic cancer patients. Insights into the molecular characteristics of pancreatic cancer may provide valuable information, leading to its earlier detection and the development of targeted therapies. Material and Methods: We conducted a systematic review and a meta-analysis of studies that reported cfDNA in pancreatic ductal adenocarcinoma (PDAC). The studies were considered eligible if they included patients with PDAC, if they had blood tests for cfDNA/ctDNA, and if they analyzed the prognostic value of cfDNA/ctDNA for patients’ survival. The studies published before 22 October 2020 were identified through the PubMED, EMBASE, Web of Science and Cochrane Library databases. The assessed outcomes were the overall (OS) and progression-free survival (PFS), expressed as the log hazard ratio (HR) and standard error (SE). The summary of the HR effect size was estimated by pooling the individual trial results using the Review Manager, version 5.3, Cochrane Collaboration. The heterogeneity was assessed using the Cochran Q test and I2 statistic. Results: In total, 48 studies were included in the qualitative review, while 44 were assessed in the quantitative synthesis, with the total number of patients included being 3524. Overall negative impacts of cfDNA and KRAS mutations on OS and PFS in PDAC (HR = 2.42, 95% CI: 1.95–2.99 and HR = 2.46, 95% CI: 2.01–3.00, respectively) were found. The subgroup analysis of the locally advanced and metastatic disease presented similar results (HR = 2.51, 95% CI: 1.90–3.31). In the studies assessing the pre-treatment presence of KRAS, there was a moderate to high degree of heterogeneity (I2 = 87% and I2 = 48%, for OS and PFS, respectively), which was remarkably decreased in the analysis of the studies measuring post-treatment KRAS (I2 = 24% and I2 = 0%, for OS and PFS, respectively). The patients who were KRAS positive before but KRAS negative after treatment had a better prognosis than the persistently KRAS-positive patients (HR = 5.30, 95% CI: 1.02–27.63). Conclusion: The assessment of KRAS mutation by liquid biopsy can be considered as an additional tool for the estimation of the disease course and outcome in PDAC patients.",
journal = "Cancers",
title = "Meta-analysis of circulating cell-free dna’s role in the prognosis of pancreatic cancer",
volume = "13",
number = "14",
pages = "3378",
doi = "10.3390/cancers13143378"
}

Milin-Lazović, J., Madžarević, P., Rajović, N., Đorđević, V., Milić, N., Pavlović, S., Veljković, N. V., Milić, N. M.,& Radenković, D.. (2021). Meta-analysis of circulating cell-free dna’s role in the prognosis of pancreatic cancer. in Cancers, 13(14), 3378.
https://doi.org/10.3390/cancers13143378

Milin-Lazović J, Madžarević P, Rajović N, Đorđević V, Milić N, Pavlović S, Veljković NV, Milić NM, Radenković D. Meta-analysis of circulating cell-free dna’s role in the prognosis of pancreatic cancer. in Cancers. 2021;13(14):3378.
doi:10.3390/cancers13143378 .

Milin-Lazović, Jelena, Madžarević, Petar, Rajović, Nina, Đorđević, Vladimir, Milić, Nikola, Pavlović, Sonja, Veljković, Nevena V., Milić, Nataša M., Radenković, Dejan, "Meta-analysis of circulating cell-free dna’s role in the prognosis of pancreatic cancer" in Cancers, 13, no. 14 (2021):3378,
https://doi.org/10.3390/cancers13143378 . .