ArticleNPJ precision oncology2026
Cell-free DNA dynamics and progression-free survival in metastatic gastroesophageal adenocarcinoma: insights from the REGIRI-PRODIGE 58 ancillary study.
Article in NPJ precision oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03722108 (A Randomised Phase 2 Trial Assessing REGorafenib Combined With IRInotecan as Second-line Treatment in Patients With Metastatic Gastro-oesophageal Adenocarcinomas), which is not on this map. Not yet cited in PubMed.
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A Randomised Phase 2 Trial Assessing REGorafenib Combined With IRInotecan as Second-line Treatment in Patients With Metastatic Gastro-oesophageal Adenocarcinomas
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20 authors.
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Abstract
Cell-free DNA (cfDNA) analysis is an emerging tool for diagnosis, prognosis, and monitoring in cancer. This ancillary study of the REGIRI-PRODIGE 58 trial (NCT03722108) evaluated cfDNA dynamics in patients with metastatic gastroesophageal adenocarcinoma (mGA) treated with regorafenib plus irinotecan. Plasma samples from 34 patients in the experimental arm were analyzed (239 samples at baseline, post-treatment initiation [days 2, 8, 15 of Cycle 1; days 1, 8, 15 of Cycle 2]). cfDNA was extracted, quantified by fluorimetry, and characterized by fragment analysis. Baseline concentrations were dichotomized into "low" and "high" subgroups using a 2.07 ng/µL threshold. Changes from baseline to the final timepoint defined four dynamic subgroups (low-low, low-high, high-low, high-high). At baseline, 27 patients (79.4%) had low cfDNA concentrations and 7 (20.5%) high ctDNA. Progression-free survival (PFS) was longer in the low group (median 4.51 months) versus the high group (median 1.60 months; p = 0.0084). Longitudinally, the low-low subgroup had longer PFS than the high-high subgroup (3.61 vs 1.45 months; p = 0.0004). Baseline and dynamic cfDNA concentrations were significantly associated with PFS in patients with mGA treated with regorafenib plus irinotecan, supporting cfDNA as a potential prognostic biomarker for validation in larger cohorts.
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