High concentration of plasma cell free DNA alerted progressive and recurrent disease in children with high risk neuroblastoma.
e21506 Background: Neuroblastoma (NB) happens most frequently among babies and it is also the third-most common cancer in children after leukemia and brain tumor. The unexpected occurrence of NB progression and relapse accounts for the low survival free event rates, therefore finding an effective biomarker to predict the progressive and recurrent events is urgent. Methods: A total of 116 NB patients with high risk (HR-NB) from Beijing Children’s Hospital between February 1, 2015 and December 31, 2017 were recruited. All patients received the regular multiple-disciplinary treatments and then followed the evaluation for therapeutic response according to the standards of Response Evaluation Criteria in Solid Tumors (RECIST). Blood samples were collected to quantify cell-free DNA levels at important time points including one week before or the beginning of maintenance stage, every or every three month after the beginning of maintenance stage, diagnosis of progression and recurrence. Results: Results showed that 36 HR-NB patients developed progressive disease (PD) and recurrent disease. More intriguingly, cfDNA concentration was extremely higher in NB patients with progression and recurrence than those with events free (29.34 ng/ml VS 10.32 ng/ml), and increasing cfDNA levels happened at least 0.55 months before the progression and recurrence was confirmed. By analyzing the area under the receiver operator characteristic (ROC) curve (AUC), it showed that the area of cfDNA level was 0.67 at 12.93 ng/ml with 62.5% sensitivity and 71.3% specificity. Conclusions: Taken together, it was suggested increasing cfDNA concentration in plasma may benefit to warn the incurrence of progression and recurrence in NB patients in clinic, which will help clinicians win much more valuable time to save patients’ lives.