Endometrial cancer is the most prevalent gynecological
cancer in developed countries. Although the prognosis of
endometrial cancer is better than that of other gynecological
cancers, the prognosis of advanced
endometrial cancer is still poor and thus new therapeutic modalities, such as immune
therapies, are urgently required. For the further development of new modalities, exploration of new
biomarkers is important. The present study investigated the circulating
cell-free DNA (
cfDNA) integrity as a ratio of the necrotic
tumor cell-derived long
cfDNA fragments to the total dead cell-derived short
cfDNA fragments from genomic Alu elements in patients with advanced
endometrial cancer during
peptide vaccination treatment. The results demonstrated that: i) The plasma
cfDNA integrity was decreased during the first cycle of vaccination in patients with
endometrial cancer treated with the personalized
peptide vaccination, and ii) the post-vaccination
cfDNA integrity levels were correlated with good prognosis. Some of these findings have been confirmed in other
cancers, and thus
cfDNA integrity might be an important marker for future
cancer vaccine therapies in general, and might also be applicable for other immune
therapies.