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ctDNA to Guide Treatment of Colorectal Cancer: Ready for Standard of Care?

作者信息

Puccini Alberto, Martelli Valentino, Pastorino Alessandro, Sciallero Stefania, Sobrero Alberto

机构信息

Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, 16132, Genoa, Italy.

Department of Internal Medicine and Medical Specialties (DIMI), School of Medicine, University of Genoa, 16132, Genoa, Italy.

出版信息

Curr Treat Options Oncol. 2023 Feb;24(2):76-92. doi: 10.1007/s11864-022-01048-x. Epub 2023 Jan 19.


DOI:10.1007/s11864-022-01048-x
PMID:36656505
Abstract

Circulating tumor DNA (ctDNA) has already shown clinically relevant results in early-stage colon cancer patient management. Its prognostic value is by far much stronger than that of the available clinico-pathological biomarkers, therefore, has the potential to personalize the treatment after radical surgery through intensifying or de-intensifying the adjuvant therapy. Further developments and improvements should be pursued by (a) optimizing ctDNA assays and (b) validating its clinical utility in the different stages of this disease. Two main avenues of ctDNA testing are being pursued: tumor-informed vs tumor-agnostic assays. Two main clinical trial designs are under study: ctDNA-based strategy and ctDNA-by-treatment interaction. The former needs large sample sizes to address the main questions of the studies; thus, the target delta benefit may be the main challenge in these trial designs. The latter may be challenged by unavoidable contamination bias. To date, several clinical trials are ongoing worldwide. We believe that this large number of trials may provide an excellent common database for the demonstration of surrogacy of ctDNA for the classical 3-year disease-free survival endpoint. This would mark a huge methodological improvement to speed up new drug testing and development in the adjuvant treatment of this disease.

摘要

相似文献

[1]
ctDNA to Guide Treatment of Colorectal Cancer: Ready for Standard of Care?

Curr Treat Options Oncol. 2023-2

[2]
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Cancer Sci. 2021-7

[3]
The Future of ctDNA-Defined Minimal Residual Disease: Personalizing Adjuvant Therapy in Colorectal Cancer.

Clin Colorectal Cancer. 2022-6

[4]
Circulating tumour DNA as a biomarker in resectable and irresectable stage IV colorectal cancer; a systematic review and meta-analysis.

Eur J Cancer. 2021-2

[5]
Circulating Tumor DNA Analyses as Markers of Recurrence Risk and Benefit of Adjuvant Therapy for Stage III Colon Cancer.

JAMA Oncol. 2019-12-1

[6]
Circulating tumor DNA guided adjuvant chemotherapy in stage II colon cancer (MEDOCC-CrEATE): study protocol for a trial within a cohort study.

BMC Cancer. 2020-8-20

[7]
Circulating tumor DNA is a sensitive marker for routine monitoring of treatment response in advanced colorectal cancer.

Carcinogenesis. 2020-11-13

[8]
CtDNA's prognostic value in patients with early-stage colorectal cancer after surgery: A meta-analysis and systematic review.

Medicine (Baltimore). 2023-2-10

[9]
Dynamic monitoring of circulating tumor DNA to predict prognosis and efficacy of adjuvant chemotherapy after resection of colorectal liver metastases.

Theranostics. 2021

[10]
Clinical application of circulating tumour DNA in colorectal cancer.

Lancet Gastroenterol Hepatol. 2023-9

引用本文的文献

[1]
Research trends and hotspots of circulating tumor DNA in colorectal cancer: a bibliometric study.

Front Oncol. 2025-5-14

[2]
Liquid Biopsy and Challenge of Assay Heterogeneity for Minimal Residual Disease Assessment in Colon Cancer Treatment.

Genes (Basel). 2025-1-9

[3]
Feasibility of ctDNA in detecting minimal residual disease and predicting recurrence for colorectal cancer liver metastases.

Front Oncol. 2024-10-8

[4]
Pioneering colorectal cancer screening: blood-based DNA tests as a global strategy for early detection - editorial.

Int J Surg. 2024-11-1

[5]
Personalizing adjuvant therapy for patients with colorectal cancer.

Nat Rev Clin Oncol. 2024-1

[6]
Circulating Tumor DNA: The Dawn of a New Era in the Optimization of Chemotherapeutic Strategies for Metastatic Colo-Rectal Cancer Focusing on Mutation.

Cancers (Basel). 2023-2-25

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