Department of Medical Oncology, Peter MacCallum Cancer Centre, 305 Grattan St, Parkville Melbourne, VIC 3000, Australia.
Division of Personalised Oncology, The Walter and Eliza Hall Institute of Medical Research, Melbourne, VIC, 3052, Australia.
Curr Oncol Rep. 2021 Nov 4;23(12):140. doi: 10.1007/s11912-021-01137-4.
Improving outcomes for patients with colorectal cancer in both the adjuvant and metastatic setting has been challenging. Here, we review the current and future directions for using ctDNA in clinical practice.
Circulating tumour DNA (ctDNA) with its ability to detect minimal residual disease is beginning to refine the way we assess recurrence risk in the adjuvant setting. We can potentially tailor treatments to reduce recurrence risk and minimize treatment toxicity. In the metastatic setting, ctDNA can provide a less invasive method of detecting clinically important genetic changes to guide molecularly targeted treatment and to identify mechanisms of molecular resistance. ctDNA can be a surrogate marker for treatment response and help guide the timing of anti-EGFR rechallenge. We await the results of the randomized clinical trials assessing clinical utility of ctDNA in both the adjuvant and metastatic setting before incorporating ctDNA into clinical practice.
改善结直肠癌患者的辅助治疗和转移性疾病的治疗效果一直具有挑战性。在这里，我们回顾了 ctDNA 在临床实践中的当前和未来方向。
循环肿瘤 DNA（ctDNA）具有检测微小残留疾病的能力，开始改变我们在辅助治疗中评估复发风险的方式。我们可以有针对性地治疗，以降低复发风险并最大限度地减少治疗毒性。在转移性疾病中，ctDNA 可以提供一种侵入性较小的方法来检测临床上重要的遗传变化，以指导分子靶向治疗，并确定分子耐药的机制。ctDNA 可以作为治疗反应的替代标志物，有助于指导抗 EGFR 再挑战的时机。我们在将 ctDNA 纳入临床实践之前，正在等待评估 ctDNA 在辅助治疗和转移性疾病中的临床效用的随机临床试验的结果。
