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Table 3 Summary of the clinical utility of eccDNA

From: Small extrachromosomal circular DNA (eccDNA): major functions in evolution and cancer

Clinical utility Type of cancer References
• Modulates the copies of oncogene-harboring eccDNAs to improve the efficacy of cancer treatment.
 (I) The elimination of eccDNAs carrying oncogenes promotes drug sensitivity. Neuroblastoma [74]
 (II) Chemotherapeutic drugs promote the elimination of eccDNA containing amplified genes. Neuroblastoma, colon cancer [74, 115]
 (III) DNA-PKs or PARP inhibitors decrease drug resistance and eccDNA production. Colorectal cancer [43]
• EccDNAs serve as promising biomarkers for cancer monitoring and prognosis.
 (I) Normal and cancerous tissues release eccDNAs into the circulation, which suggests promising potential for liquid biopsy. Ovarian cancer, lung cancer [110, 113]
 (II) Patients with eccDNA carrying amplified MYCN exhibit worse overall survival than patients with MYCN-amplified tumors lacking such rearrangements. Neuroblastoma [6]
 (III) EccDNA in the circulation is sharply decreased after surgery in patients with cancer. Ovarian cancer, lung cancer [110]
 (IV) EccDNA is responsible for tumor recurrence. Glioblastoma multiforme [72]
• EccDNA serves as a promising tool for tracing the origin of the primary cancer.
 (I) The presence of eccDNA in the circulation is helpful for discriminating the origin of primary cancer. NA [114]
 (II) The methylation status of eccDNA in the circulation is different and unique under specific physiological conditions, which makes eccDNA a trace biomarker. Not applicable [22]
  1. NA Not available