Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Department of Oncology, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Oncologist. 2024 Mar 4;29(3):e414-e418. doi: 10.1093/oncolo/oyad336.
Despite advances in treatment and response assessment in locally advanced rectal cancer (LARC), it is unclear which patients should undergo nonoperative management (NOM). We performed a single-center, retrospective study to evaluate post-total neoadjuvant therapy (TNT) circulating tumor DNA (ctDNA) in predicting treatment response. We found that post-TNT ctDNA had a sensitivity of 23% and specificity of 100% for predicting residual disease upon resection, with a positive predictive value (PPV) of 100% and a negative predictive value (NPV) of 47%. For predicting poor tumor regression on MRI, ctDNA had a sensitivity of 16% and specificity of 96%, with a PPV of 75% and NPV of 60%. A commercially available ctDNA assay was insufficient to predict residual disease after TNT and should not be used alone to select patients for NOM in LARC.
尽管在局部晚期直肠癌（LARC）的治疗和反应评估方面取得了进展，但仍不清楚哪些患者应接受非手术治疗（NOM）。我们进行了一项单中心回顾性研究，以评估新辅助治疗后（TNT）循环肿瘤 DNA（ctDNA）在预测治疗反应方面的作用。我们发现，TNT 后 ctDNA 对预测切除时残留疾病的敏感性为 23%，特异性为 100%，阳性预测值（PPV）为 100%，阴性预测值（NPV）为 47%。对于预测 MRI 上肿瘤不良消退，ctDNA 的敏感性为 16%，特异性为 96%，PPV 为 75%，NPV 为 60%。一种商业化的 ctDNA 检测方法不足以预测 TNT 后的残留疾病，不应单独用于选择 LARC 患者进行 NOM。
Zotero 插件