{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T21:38:20Z","timestamp":1791581900630,"version":"4.3.4"},"reference-count":77,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T00:00:00Z","timestamp":1781222400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Background: Extrachromosomal DNA (ecDNA) amplification represents a distinct mechanism of genomic instability in cancer, increasingly recognized for its role in aggressive disease progression. This review examines how ecDNA drives tumour evolution and assesses its potential as both a prognostic marker and therapeutic target. Methods: The authors integrate findings from multiple detection platforms\u2014including FISH, whole-genome sequencing, and specialized reconstruction algorithms\u2014and present data across diverse cancer types; no preregistration is noted, and no animal studies are included. Results: ecDNA consists of circular, acentric DNA elements carrying high-copy oncogene amplifications (such as EGFR, MYC, MDM2, and CDK4). Unlike chromosomal DNA, ecDNA segregates unevenly during cell division, generating intratumoral heterogeneity, accelerating adaptation to selective pressures, and promoting resistance to therapy. Pan-cancer surveys summarized here reveal ecDNA in a significant subset of tumours, with particularly high frequencies in liposarcoma, glioblastoma, and HER2-positive breast cancer, and consistent associations with worse clinical outcomes. Conclusions: The authors conclude that ecDNA amplification serves as a credible adverse prognostic indicator and holds promise for refining risk stratification and guiding treatment strategies. However, they stress that clinical adoption remains constrained by the absence of standardized, scalable, and reproducible detection.<\/jats:p>","DOI":"10.3390\/jpm16060316","type":"journal-article","created":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T05:59:47Z","timestamp":1781503187000},"page":"316","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Extrachromosomal DNA Amplification as a Prognostic Factor for Cancer"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-5982-861X","authenticated-orcid":false,"given":"Filip","family":"Gajewski","sequence":"first","affiliation":[{"name":"Student Scientific Association, The Department of Pneumonology, Oncology and Allergology, Medical University of Lublin, Doktora Kazimierza Jaczewskiego 8, 20-090 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-5525-7338","authenticated-orcid":false,"given":"Joanna","family":"Pec","sequence":"additional","affiliation":[{"name":"Student Scientific Association, The Department of Pneumonology, Oncology and Allergology, Medical University of Lublin, Doktora Kazimierza Jaczewskiego 8, 20-090 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-3742-5696","authenticated-orcid":false,"given":"Jakub","family":"Kleinrok","sequence":"additional","affiliation":[{"name":"Chair and Department of Clinical Pathomorphology, Medical University of Lublin, Kazimierza Jaczewskiego 8b, 20-090 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-9616-0458","authenticated-orcid":false,"given":"Weronika","family":"Paj\u0105k","sequence":"additional","affiliation":[{"name":"Student Scientific Association, The Department of Pneumonology, Oncology and Allergology, Medical University of Lublin, Doktora Kazimierza Jaczewskiego 8, 20-090 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katarzyna","family":"Pacyna","sequence":"additional","affiliation":[{"name":"Student Scientific Association, The Department of Pneumonology, Oncology and Allergology, Medical University of Lublin, Doktora Kazimierza Jaczewskiego 8, 20-090 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9539-1697","authenticated-orcid":false,"given":"Agata","family":"Tokarzewska","sequence":"additional","affiliation":[{"name":"Student Scientific Association, The Department of Pneumonology, Oncology and Allergology, Medical University of Lublin, Doktora Kazimierza Jaczewskiego 8, 20-090 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pawe\u0142","family":"Krawczyk","sequence":"additional","affiliation":[{"name":"Department of Pneumonology, Oncology and Allergology, Medical University of Lublin, Doktora Kazimierza Jaczewskiego 8, 20-090 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1007\/s10555-013-9429-5","article-title":"The detection and implication of genome instability in cancer","volume":"32","author":"Pikor","year":"2013","journal-title":"Cancer Metastasis Rev."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1038\/nrm2858","article-title":"Genomic instability\u2014An evolving hallmark of cancer","volume":"11","author":"Negrini","year":"2010","journal-title":"Nat. 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