Postoperative Circulating Tumour DNA in Predicting Recurrence of Non-small Cell Lung Cancer: A Systematic Review and Meta-analysis

Abstract

Aims: Circulating tumour DNA (ctDNA) has become a noninvasive biomarker for dynamic monitoring of tumours. However, available evidence on postoperative ctDNA in patients with non-small cell lung cancer (NSCLC) is limited. This systematic review and meta-analysis aims to appraise the prognostic value of postoperative ctDNA in NSCLC.

Materials and methods: PubMed, Cochrane, Web of Science, and Embase were retrieved until May 20, 2024, to identify potentially eligible studies. The primary outcomes were relapse-free survival (RFS) and overall survival (OS) based on the status of postoperative ctDNA. Subgroup analyses were conducted according to baseline characteristics. Data quality were appraised using the Newcastle-Ottawa scale. The meta-analysis was performed using Stata18.

Results: Total of 13 studies on predicting NSCLC recurrence based on postoperative ctDNA were included. According to the meta-analysis, postoperative ctDNA-positive patients had markedly shorter RFS (HR = 6.05, 95% CI: 4.48-8.18, P < 0.01) compared to ctDNA-negative patients. Furthermore, ctDNA-positive patients exhibited a shorter OS (HR = 4.53, 95% CI: 2.56-8.02, P < 0.01) than ctDNA-negative patients.

Conclusion: Postoperative ctDNA detection can predict tumour recurrence and overall survival in NSCLC patients.

Prospero registration number: CRD42024577421.

Keywords: Meta-analysis; OS; RFS; non-small cell lung cancer; postoperative ctDNA.