Quantification of circulating cell-free DNA to predict patient survival in non-small-cell lung cancer

Myung Han Hyun, Jae Sook Sung, Eun Joo Kang, Yoon Ji Choi, Kyong Hwa Park, Sang Won Shin, Sung Yong Lee, Yeul Hong Kim

Research output: Contribution to journalArticlepeer-review

25 Citations (Scopus)


We used computed tomography (CT) to explore the prognostic value of cellfree (cf) DNA quantification and its predictive efficacy over time after chemotherapy in non-small-cell lung cancer (NSCLC) patients. In total, 177 NSCLC patients were enrolled in a prospective biomarker trial. Consecutive paired blood collection was performed to determine cfDNA concentrations at baseline CT and throughout serial follow-ups. The best cfDNA cut-off value to predict progression-free and overall survival was determined using X-tile analysis. Among 112 chemo-naive patients with stage IV adenocarcinoma, 43 were available for follow-up analysis. Cox regression multivariate analysis indicated that a high cfDNA concentration was an independent negative prognostic factor for progression-free survival (hazard ratio: 2.60; 95% confidence interval: 1.65-4.10; p = 0.008) and overall survival (hazard ratio: 2.63; 95% confidence interval: 1.66-4.17; p < 0.001). However, cfDNA concentration changes during treatment did not correlate with radiological CT responses at first follow-up or best response. No pattern was noted in the percent change in the cfDNA concentration from baseline or subsequently measured level to progression. The serum cfDNA concentration is thus associated with NSCLC patient prognosis, but does not appear to be a clinically valid marker for tumor responses.

Original languageEnglish
Pages (from-to)94417-94430
Number of pages14
Issue number55
Publication statusPublished - 2017 Nov 1

Bibliographical note

Funding Information:
The authors thank the patients and their families. This research was supported by the Korea Health Technology R&D Project through the Korea Health Industry Development Institute, funded by the Ministry of Health & Welfare, Republic of Korea (HI14C0066), and the Bio & Medical Technology Development Program of the National Research Foundation funded by the Korean government, Ministry of Science, ICT and Future Planning (NRF-2015M3A9D7031070).

Publisher Copyright:
© Hyun et al.


  • Cell-free DNA concentration
  • Non-small-cell lung cancer
  • Prognostic value

ASJC Scopus subject areas

  • Oncology


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