Table 3.
Clinical implications of ecDNA in cancer.
| Category | Potential implications | References |
|---|---|---|
| Diagnostic biomarker | • ecDNA could serve as diagnostic biomarkers in plasma samples for lung cancer. | (62, 73, 79) |
| Prognostic biomarker | • Some ecDNA were associated with compromised survival in various cancers, e.g. glioblastoma and HGSOC. • Some ecDNA were associated with better prognosis in gastric cardia adenocarcinoma. |
(6, 42) |
| (56) | ||
| Drug resistance | • Oncogene amplicons carried by ecDNA can accelerate the development of intra-tumoral heterogeneity. • ecDNA can serve as a latent reservoir for genomic alterations. |
(5, 49, 72, 84–88) |
| (24, 89) | ||
| Therapeutic target | • Hydroxyurea restored drug sensitivity. • PARP inhibitors may target the reintegration of ecDNA. • BET inhibitors may target ecDNA hubs. • Treatments could be developed to induce antigen presentation pathways. |
(90, 91) |
| (36) | ||
| (45) | ||
| (92) |