Cerebrospinal fluid ctDNA as a prognostic and disease-activity biomarker in leptomeningeal metastases: systematic review, meta-analysis, and implications for CSF-guided care.
메타분석
1/5 보강
[PURPOSE] Leptomeningeal disease (LMD) is a devastating complication of advanced solid tumors with limited prognostic and response-assessment tools.
- 표본수 (n) 963
- 95% CI 1.73-3.33
- 연구 설계 systematic review
APA
Sankar BS, Johnson D, et al. (2026). Cerebrospinal fluid ctDNA as a prognostic and disease-activity biomarker in leptomeningeal metastases: systematic review, meta-analysis, and implications for CSF-guided care.. Journal of neuro-oncology, 177(2). https://doi.org/10.1007/s11060-026-05520-8
MLA
Sankar BS, et al.. "Cerebrospinal fluid ctDNA as a prognostic and disease-activity biomarker in leptomeningeal metastases: systematic review, meta-analysis, and implications for CSF-guided care.." Journal of neuro-oncology, vol. 177, no. 2, 2026.
PMID
41886011 ↗
Abstract 한글 요약
[PURPOSE] Leptomeningeal disease (LMD) is a devastating complication of advanced solid tumors with limited prognostic and response-assessment tools. Because LMD molecular evolution is frequently compartmentalized behind CNS barriers, cerebrospinal fluid (CSF) circulating tumor DNA (ctDNA) may provide CNS-specific molecular readouts of disease activity. We evaluated whether baseline CSF ctDNA profiles and longitudinal ctDNA kinetics associate with survival in LMD.
[METHODS] We performed a systematic review and meta-analysis (PROSPERO CRD420251068543) of Embase, PubMed, Cochrane CENTRAL, WHO ICTRP, ClinicalTrials.gov, Europe PMC, and Web of Science from inception through June 2025. Eligible studies included adults with solid-tumor LMD undergoing anti-cancer therapy with CSF ctDNA assessed at baseline and/or serially and reported associations with overall survival (OS) and/or progression-free survival (PFS). Random-effects models pooled hazard ratios (HRs). Longitudinal studies were analyzed separately due to limited availability.
[RESULTS] Fourteen studies (n = 963) evaluated baseline CSF ctDNA and two studies (n = 26) evaluated longitudinal kinetics. Adverse (non-reference) baseline ctDNA status (e.g., EGFR mutation positive vs. negative) was associated with inferior OS (pooled HR 2.40, 95% CI 1.73-3.33; I²=36.6%) and PFS (pooled HR 2.45, 95% CI 1.36-4.44; I²=15.5%). Longitudinally, increasing CSF ctDNA variant allele fraction was associated with worse OS (pooled HR 4.11, 95% CI 1.25-13.48; I²=8.5%). Across longitudinal reports, serial CSF ctDNA measurements tracked progression and response.
[CONCLUSION] Baseline and serial CSF ctDNA measurements are associated with survival outcomes in LMD and may complement clinical and radiographic assessment. These findings support prospective, standardized, multi-timepoint CSF ctDNA studies in LMD and warrant CSF-access-enabled monitoring to inform therapeutic adaptation.
[METHODS] We performed a systematic review and meta-analysis (PROSPERO CRD420251068543) of Embase, PubMed, Cochrane CENTRAL, WHO ICTRP, ClinicalTrials.gov, Europe PMC, and Web of Science from inception through June 2025. Eligible studies included adults with solid-tumor LMD undergoing anti-cancer therapy with CSF ctDNA assessed at baseline and/or serially and reported associations with overall survival (OS) and/or progression-free survival (PFS). Random-effects models pooled hazard ratios (HRs). Longitudinal studies were analyzed separately due to limited availability.
[RESULTS] Fourteen studies (n = 963) evaluated baseline CSF ctDNA and two studies (n = 26) evaluated longitudinal kinetics. Adverse (non-reference) baseline ctDNA status (e.g., EGFR mutation positive vs. negative) was associated with inferior OS (pooled HR 2.40, 95% CI 1.73-3.33; I²=36.6%) and PFS (pooled HR 2.45, 95% CI 1.36-4.44; I²=15.5%). Longitudinally, increasing CSF ctDNA variant allele fraction was associated with worse OS (pooled HR 4.11, 95% CI 1.25-13.48; I²=8.5%). Across longitudinal reports, serial CSF ctDNA measurements tracked progression and response.
[CONCLUSION] Baseline and serial CSF ctDNA measurements are associated with survival outcomes in LMD and may complement clinical and radiographic assessment. These findings support prospective, standardized, multi-timepoint CSF ctDNA studies in LMD and warrant CSF-access-enabled monitoring to inform therapeutic adaptation.
🏷️ 키워드 / MeSH 📖 같은 키워드 OA만
🏷️ 같은 키워드 · 무료전문 — 이 논문 MeSH/keyword 기반
- A Phase I Study of Hydroxychloroquine and Suba-Itraconazole in Men with Biochemical Relapse of Prostate Cancer (HITMAN-PC): Dose Escalation Results.
- Self-management of male urinary symptoms: qualitative findings from a primary care trial.
- Clinical and Liquid Biomarkers of 20-Year Prostate Cancer Risk in Men Aged 45 to 70 Years.
- Diagnostic accuracy of Ga-PSMA PET/CT versus multiparametric MRI for preoperative pelvic invasion in the patients with prostate cancer.
- Association of patient health education with the postoperative health related quality of life in low- intermediate recurrence risk differentiated thyroid cancer patients.
- Early local immune activation following intra-operative radiotherapy in human breast tissue.