Circulating DNA is a useful prognostic factor in @entity1 with advanced XXXX .

@entity1 @entity1149 @entity2 @entity900 @entity1054 @entity2215 @entity1205 @entity1349
BACKGROUND: Circulating DNA is observed at higher concentrations in @entity1 with @entity2 than in controls. Qualitative and quantitative analysis of circulating DNA is a promising noninvasive tool. Our aim was to prospectively study the association between the catalytic subunit of telomerase ( @entity1 telomerase reverse transcriptase [ @entity2215 ]) in plasma and clinical variables and survival in a large-scale @entity1149 ( @entity1149 ) study. METHODS: Four hundred forty-six @entity1 with stages IIIB and IV @entity1149 with a median follow-up of 9.7 months (range, 0.5-45) were analyzed. Blood samples were collected before therapy start ( @entity900 / @entity1205 ). Quantification of baseline circulating DNA was determined as the amount of free @entity2215 in plasma, by using real-time quantitative polymerase chain reaction. RESULTS: @entity1 with @entity2215  <= 49.8 ng/ml (median value) had a median @entity1054 ( @entity1054 ) of 6.3 months compared with 4.9 for @entity2215 more than 49.8 ng/ml (p = 0.001). @entity1349 ( @entity1349 ) was significantly higher (10.9 versus 9.3 months) at lower @entity2215 levels (p = 0.012). When calculations were done using @entity2215 as continuous variable, we did not observe independent significant differences. Thus, there is an apparent discrepancy in p values when @entity2215 is considered as a continuous versus dichotomized variable. There was a tendency to differentiate median @entity2215 levels with respect to response rates (complete response + partial response: 33.1 versus stable disease + progressive disease: 50.7 ng/ml, p = 0.12), but other clinical variables such as age, gender, performance status, stage, histology, and number of metastatic locations were not associated with @entity2215 . In multivariate analysis, @entity2215 was an independent prognostic variable for both @entity1054 (hazard ratio: 1.44, p < 0.001) and @entity1349 (hazard ratio: 1.33, p = 0.007). CONCLUSIONS: In advanced @entity1149 , high pretreatment circulating @entity2215 level is an independent poor prognostic marker for @entity1054 and @entity1349 . Circulating DNA is a noninvasive marker, which may help to improve the prognostic profile of these @entity1 .
