Concentration of cell-free DNA in cancer

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 Earlier we saw how cell-free DNA is released into the body fluids. That raises a lot of questions... Does the amount of DNA vary from person-to-person? Can the DNA levels be different in people with diseases than in normal people? Yes, they can be... 

cfDNA levels in cancer


For example, in cancer, researchers have measured cfDNA levels using many techniques. Some of them are radioimmunoassay, DNA dipstick, and real-time PCR. Different studies have reported different levels of cfDNA. But in general, cancer patients had higher cfDNA concentration than healthy people. Some studies compared cell-free levels in different cancer types. Of these, lung cancer patients had the highest levels of cell-free DNA. And prostate cancer patients had the lowest levels.

So how can this information help in treating disease? To answer this, researchers compared DNA levels with patients' clinical information. They found that patients with bigger tumors had higher cell-free DNA levels. Patients with higher disease stage and low rate of survival also had higher cfDNA levels. Patients, whose cancer had spread to other organs, also had higher cfDNA levels.

So, this must mean that with a proper cut-off level, doctors can detect if a cancer has spread. Right? 

This was about cancer diagnosis. What about treatment? Well, researchers compared cell-free DNA levels before and after treatment. They observed lower cfDNA levels after therapy or surgery. This indicated that the patient's condition had improved.

Higher cfDNA levels during treatment indicated that the disease was progressing. No change in levels also indicated that the patient was not responding to treatment. Patients without disease after treatment also had lower cfDNA levels. Patients having relapse of disease had higher levels. 

Many groups have compared cfDNA levels in malignant cancer patients, people with benign tumors and normal people. Some reports say that cfDNA concentration was very high in malignant cancer patients. It was moderate in benign disease, and low in healthy people. But there were also cases where there was no difference in benign and malignant disease. Such cases would make it difficult to establish a cut-off value. But, as we have seen above, cfDNA levels change according to disease status and effect of therapy. So, to improve efficacy, cfDNA can be combined with other parameters such as mutations and DNA integrity for treatment monitoring. 


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