American journal of translational research · 2026
Circulating tumor DNA mediates the effect of intrapleural cisplatin retention on non-small cell lung cancer malignant pleural effusion.
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Shi Hailong, Liu Shixin, Yuan Zhiwei, Hao Yankun, Liu Yanbing
Аннотация
OBJECTIVES: To analyze the therapeutic effects of different cisplatin retention times on malignant pleural effusion and to explore whether circulating tumor DNA (ctDNA) played a mediating role in this process.
METHODS: A total of 207 patients with non-small cell lung cancer (NSCLC) and pleural effusion were enrolled. According to the retention time after intrapleural injection of cisplatin, patients were divided into three groups: a 1 h retention group (n=68), a 6 h retention group (n=69), and a 24 h retention group (n=70). The short-term efficacy (disease control rate, objective response rate) and long-term efficacy (progression-free survival, overall survival (OS)) were compared among the three groups, and the role of ctDNA was explored through mediation effect analysis.
RESULTS: The disease control rate in the 24 h retention group was 92.9%, significantly higher than that in the 6 h group (92.7%) and the 1 h group (80.9%) (P<0.05). Regarding survival outcomes, the median progression-free survival (PFS) in the 24 h group was 11.8 months, and the median OS was 18.5 months, both significantly longer than those in the 6 hr and 1 h groups (P<0.001). Mediation analysis showed that ctDNA concentration played a partial mediating role in the association between cisplatin retention duration and patient survival (both PFS and OS).
CONCLUSIONS: 24 h intrapleural cisplatin retention significantly improves the short-term and long-term treatment outcomes in NSCLC patients with pleural effusion. Changes in ctDNA concentration play a key mediating role in this efficacy improvement, suggesting that ctDNA could serve as a novel potential biomarker for guiding personalized treatment.
METHODS: A total of 207 patients with non-small cell lung cancer (NSCLC) and pleural effusion were enrolled. According to the retention time after intrapleural injection of cisplatin, patients were divided into three groups: a 1 h retention group (n=68), a 6 h retention group (n=69), and a 24 h retention group (n=70). The short-term efficacy (disease control rate, objective response rate) and long-term efficacy (progression-free survival, overall survival (OS)) were compared among the three groups, and the role of ctDNA was explored through mediation effect analysis.
RESULTS: The disease control rate in the 24 h retention group was 92.9%, significantly higher than that in the 6 h group (92.7%) and the 1 h group (80.9%) (P<0.05). Regarding survival outcomes, the median progression-free survival (PFS) in the 24 h group was 11.8 months, and the median OS was 18.5 months, both significantly longer than those in the 6 hr and 1 h groups (P<0.001). Mediation analysis showed that ctDNA concentration played a partial mediating role in the association between cisplatin retention duration and patient survival (both PFS and OS).
CONCLUSIONS: 24 h intrapleural cisplatin retention significantly improves the short-term and long-term treatment outcomes in NSCLC patients with pleural effusion. Changes in ctDNA concentration play a key mediating role in this efficacy improvement, suggesting that ctDNA could serve as a novel potential biomarker for guiding personalized treatment.