Cell-Free Circulating DNA

This editorial article introduces a renaming of journal Exosomes and Microvesicles (EXMV) to the Journal of Circulating Biomarkers with a new editorial scope, mission and our approach for the upcoming year in relation to engaging at the international level, the translational art of the study of exosomes and microvesicles, and the interface between exosomes and microvesicles, circulating tumor cells, cell-free circulating DNA and circulating protein markers in precision medicine and drug development. There is a slight change in the members of the Editors in Chief, Editorial Board and extending collaborations to international societies, such as the American Society for Exosomes and Microvesicles (ASEMV).

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Vemurafenib provides a rapid and robust clinical response in paediatric Langerhans cell histiocytosis with the BRAF V600E mutation but does not eliminate low-level minimal residual disease based on ddPCR using cell-free circulating DNA

10.22541/au.160700442.27526762/v1 ◽

2020 ◽

Author(s):

Dmitry Evseev ◽

Irina Kalinina ◽

Elena Raykina ◽

Daria Osipova ◽

Zalina Abashidze ◽

...

Keyword(s):

Langerhans Cell Histiocytosis ◽

Residual Disease ◽

Braf V600e Mutation ◽

Langerhans Cell ◽

Braf V600e ◽

Circulating Dna ◽

Neutropenic Sepsis ◽

Day Range ◽

Droplet Pcr ◽

Free Circulating Dna

Background Langerhans cell histiocytosis (LCH) involves abnormal proliferation of Langerhans cells (LC), which is typically driven by the BRAF V600E mutation. High-risk LCH has a poor prognosis. Procedure Fifteen children (5 girls, 10 boys) with BRAF V600E+ LCH received vemurafenib (initial dose median 40 mg/kg/day, range: 11–51.6 mg/kg/day) between March 2016 and February 2020. All patients had previous received LCH-directed chemotherapy. The median age at LCH onset was 2 months (range: 1–28 months) and the median age at the start of vemurafenib treatment was 22 months (range: 13–62 months). The median disease activity score (DAS) at the start of vemurafenib treatment was 12 points (range: 2–22 points). Results The median duration of vemurafenib therapy was 29 months (range: 2.4–45 months). All patients responded to treatment, with median DAS values of 4 points (range: 0–14 points) at week 4 and 1 point (range: 0–3 points) at week 26. Toxicities included skin/hair changes (93%) and non-significant QT prolongation (73%). Two patients died, including 1 patient who experienced hepatic failure after NSAID overdose and 1 patient who developed neutropenic sepsis. Electively stopping vemurafenib treatment resulted in relapse in 5 patients, and complete cessation was only possible for 1 patient. Digital droplet PCR for BRAF V600E using cell-free circulating DNA revealed that 7 patients had mutation statuses that fluctuated over time. Conclusion Our study confirms that vemurafenib treatment is safe and effective for young children with BRAF V600E+ multisystem LCH. However, treatment using vemurafenib does not completely eliminate the disease.

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