2022 Fiscal Year Final Research Report

Establishment of precisoin medicine for malti-omics approaches using cancer tissue

Research Project

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Project/Area Number	20H03815
Research Category	Grant-in-Aid for Scientific Research (B)
Allocation Type	Single-year Grants
Section	一般
Review Section	Basic Section 56030:Urology-related
Research Institution	Fukushima Medical University
Principal Investigator	Uemura Motohide 福島県立医科大学, 医学部, 特任教授 (40631015)
Co-Investigator(Kenkyū-buntansha)	阿部雄一愛知県がんセンター(研究所), 分子診断TR分野, 主任研究員 (30731632) 加藤大悟大阪大学, 大学院医学系研究科, 助教 (70648021) 山口類愛知県がんセンター(研究所), システム解析学分野, 分野長 (90380675) 小島祥敬福島県立医科大学, 医学部, 教授 (60305539) 洪陽子大阪大学, 大学院医学系研究科, 招へい教員 (70824754)
Project Period (FY)	2020-04-01 – 2023-03-31
Keywords	尿路上皮がん / 血液バイオマーカー / ctDNA / 次世代シークエンス
Outline of Final Research Achievements	The first objective of this study was to verify whether perioperative circulating tumor DNA (ctDNA) analysis using a pan-cancer gene panel and next-generation sequencing could identify patients with poor prognosis who require perioperative chemotherapy. Second, we investigated whether ctDNA is useful for minimal residual disease (MRD) detection and treatment monitoring in UTUC. We performed targeted ultradeep sequencing of plasma cell-free DNA (cfDNA) and buffy coat DNA and whole-exome sequencing of cancer tissues, allowing exclusion of possible false positives. Among preoperative risk factors, only the preoperative ctDNA fraction>2% was a significant and independent risk factor associated with worse recurrence-free survival (RFS). Furthermore, the existence of ctDNA early points after the operation was significantly associated with worse RFS, suggesting the presence of MRD. Detection of ctDNA may indicate potential metastasis and guide decisions on perioperative chemotherapy.
Free Research Field	泌尿器がん
Academic Significance and Societal Importance of the Research Achievements	本研究の結果を踏まえて、前向きの臨床研究を計画している。それにより、術後早期の尿路上皮がんの再発を簡便にモニタリングすることができるようになり、適切な予防あるいは早期の治療を行うことができることになり、社会的意義は大きいものと考えられる。