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. 2024 Jun:195:110224.
doi: 10.1016/j.radonc.2024.110224. Epub 2024 Mar 11.

A systematic review of circulating predictive and prognostic biomarkers to aid the personalised use of radiotherapy in the radical treatment of patients with oesophageal cancer

Dylan P McClurg  1 , Chandan Sanghera  1 , Somnath Mukherjee  2 , Rebecca C Fitzgerald  3 , Christopher M Jones  4
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Free article

A systematic review of circulating predictive and prognostic biomarkers to aid the personalised use of radiotherapy in the radical treatment of patients with oesophageal cancer

Dylan P McClurg et al. Radiother Oncol. 2024 Jun.
Free article

Abstract

Background: The availability of circulating biomarkers that are predictive of treatment response or prognostic of overall outcome could enable the personalised and adaptive use of radiotherapy (RT) in patients with oesophageal adenocarcinoma (OAC) and squamous cell carcinoma (OSCC).

Methods: A systematic review was carried out following Preferred Reporting Items for Systematic Reviews guidance. Medline, EMBASE, PubMed, Cochrane Library, CINAHL, Scopus and the Web of Science databases were searched for studies published between January 2005-February 2023 relating to circulating biomarkers evaluated in the context of neoadjuvant or definitive RT delivered for OAC/OSCC. Study quality was assessed using predefined criteria.

Results: A total of 3012 studies were screened and 57 subsequently included, across which 61 biomarkers were reported. A majority (43/57,75.4%) of studies were of Asian origin and retrospective (40/57, 70.2%), with most (52/57, 91.2%) biomarkers reported in the context of patients with OSCC. There was marked inter-study heterogeneity in patient populations, treatment characteristics, biomarker measurement and the cut points used to define biomarker positivity. Nevertheless, there is evidence for the prognostic and predictive value of circulating tumour DNA and numerous miRNAs in OAC and OSCC, as well as for the prognostic and predictive value of circulating levels of CYFRA21.1 in OSCC.

Conclusions: There is consistent evidence for the potential predictive and prognostic value of a small number of biomarkers in OSCC and OAC, though these data are insufficient for translation to current clinical practice. Well-designed prospective studies are now required to validate their role in stratified and personalised RT treatment approaches.

Keywords: Biomarker; Oesophageal adenocarcinoma; Oesophageal squamous cell carcinoma; Predictive; Prognostic.

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Conflict of interest statement

Declaration of competing interest RCF is named on patents related to Cytosponge and related assays, which have been licensed by the Medical Research Council to Covidien GI Solutions (now Medtronic), and is a co-founder of Cyted Limited. The other authors have no competing interest to declare.

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