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将循环肿瘤DNA整合到结直肠癌临床管理中:实际意义与治疗挑战

Integrating Circulating Tumor DNA into Clinical Management of Colorectal Cancer: Practical Implications and Therapeutic Challenges.

作者信息

Vojjala Nikhil, Gibatova Viktoriya, Shah Raj N, Singal Sakshi, Prabhu Rishab, Krishnamoorthy Geetha, Riggins Karen, Moka Nagaishwarya

机构信息

Department of Internal Medicine, Trinity Health Oakland Hospital, Pontiac, MI 48341, USA.

School of Medicine, Ross University, Miami, FL 33130, USA.

出版信息

Cancers (Basel). 2025 Jul 30;17(15):2520. doi: 10.3390/cancers17152520.


DOI:10.3390/cancers17152520
PMID:40805216
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12346868/
Abstract

The American Cancer Society estimates that over 152,000 new cases of colorectal cancer (CRC) were diagnosed in 2024, with more than 105,000 cases affecting the colon and 46,000 involving the rectum. CRC remains the second leading cause of cancer-related deaths in the United States, with an estimated 53,010 deaths in 2024. In the era of precision medicine, which incorporates molecular and environmental information into clinical decision-making, identifying patients harboring a deficiency in Deoxyribonucleic acid (DNA) repair allowed for targeted immunotherapies and significantly reduced CRC-related mortality. A significant advancement in this domain is the application of liquid biopsy, which has emerged as a promising tool for prognostication, guiding therapy, and monitoring treatment response in CRC. This review aims to comprehensively explore the role of liquid biopsy in colorectal malignancies, describing its practical applications, prognostic significance, and potential to revolutionize CRC management in the future. At the end, we also aim to show a schematic representation of showing integration of Circulating Tumor (Ct) DNA in routine clinical management of CRC. The highlight of this article is the structured and evidence-based schematic framework and its integration into future practice. The schematic pathway is designed to optimize ctDNA utilization across various stages of colorectal cancer management.

摘要

美国癌症协会估计,2024年有超过15.2万例新的结直肠癌(CRC)病例被诊断出来,其中超过10.5万例影响结肠,4.6万例涉及直肠。CRC仍然是美国癌症相关死亡的第二大主要原因,2024年估计有53010人死亡。在将分子和环境信息纳入临床决策的精准医学时代,识别出患有脱氧核糖核酸(DNA)修复缺陷的患者,从而实现了靶向免疫疗法,并显著降低了CRC相关的死亡率。这一领域的一项重大进展是液体活检的应用,它已成为CRC预后评估、指导治疗和监测治疗反应的一种有前景的工具。本综述旨在全面探讨液体活检在结直肠恶性肿瘤中的作用,描述其实际应用、预后意义以及未来革新CRC管理的潜力。最后,我们还旨在展示循环肿瘤(Ct)DNA在CRC常规临床管理中的整合示意图。本文的亮点是结构化且基于证据的示意图框架及其融入未来实践。该示意图路径旨在优化ctDNA在结直肠癌管理各个阶段的利用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9ab2/12346868/86b11c50b56b/cancers-17-02520-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9ab2/12346868/b5a7893ef232/cancers-17-02520-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9ab2/12346868/4d2c8ea98be4/cancers-17-02520-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9ab2/12346868/969e19dcf85f/cancers-17-02520-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9ab2/12346868/86b11c50b56b/cancers-17-02520-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9ab2/12346868/b5a7893ef232/cancers-17-02520-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9ab2/12346868/4d2c8ea98be4/cancers-17-02520-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9ab2/12346868/969e19dcf85f/cancers-17-02520-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9ab2/12346868/86b11c50b56b/cancers-17-02520-g004.jpg

相似文献

[1]
Integrating Circulating Tumor DNA into Clinical Management of Colorectal Cancer: Practical Implications and Therapeutic Challenges.

Cancers (Basel). 2025-7-30

[2]
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[3]
Can a Liquid Biopsy Detect Circulating Tumor DNA With Low-passage Whole-genome Sequencing in Patients With a Sarcoma? A Pilot Evaluation.

Clin Orthop Relat Res. 2025-1-1

[4]
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[5]
Recent advances in liquid biopsy for precision oncology: emerging biomarkers and clinical applications in lung cancer.

Future Oncol. 2025-8-5

[6]
Guaiac-based faecal occult blood tests versus faecal immunochemical tests for colorectal cancer screening in average-risk individuals.

Cochrane Database Syst Rev. 2022-6-6

[7]
Circulating-tumour DNA methylation of HAND1 gene: a promising biomarker in early detection of colorectal cancer.

BMC Med Genomics. 2024-4-30

[8]
Impact of residual disease as a prognostic factor for survival in women with advanced epithelial ovarian cancer after primary surgery.

Cochrane Database Syst Rev. 2022-9-26

[9]
ctDNA-guided adjuvant immunotherapy in colorectal cancer.

Immunotherapy. 2024

[10]
Prognostic Significance of Circulating Tumor DNA Mutations in Gastrointestinal Stromal Tumors: A Systematic Review and Meta-analysis Based on Time-To-Event Data.

J Gastrointest Cancer. 2025-7-15

本文引用的文献

[1]
Combined Analyses of Circulating Tumor DNA and Immunoscore in Patients With Stage III Colon Cancer: A Post Hoc Analysis of the PRODIGE-GERCOR IDEA-France/HORG-IDEA-Greece Trials.

J Clin Oncol. 2025-5

[2]
Multi-cancer early detection tests for general population screening: a systematic literature review.

Health Technol Assess. 2025-1

[3]
The emerging role of blood-based biomarkers in early detection of colorectal cancer: A systematic review.

Cancer Treat Res Commun. 2024

[4]
Combination of Hotspot Mutations With Methylation and Fragmentomic Profiles to Enhance Multi-Cancer Early Detection.

Cancer Med. 2025-1

[5]
ctDNA-based molecular residual disease and survival in resectable colorectal cancer.

Nat Med. 2024-11

[6]
Clinical Validity and Utility of Circulating Tumor DNA (ctDNA) Testing in Advanced Non-small Cell Lung Cancer (aNSCLC): A Systematic Literature Review and Meta-analysis.

Mol Diagn Ther. 2024-9

[7]
Circulating tumour DNA in patients with hepatocellular carcinoma across tumour stages and treatments.

Gut. 2024-10-7

[8]
Tissue-Free Liquid Biopsies Combining Genomic and Methylation Signals for Minimal Residual Disease Detection in Patients with Early Colorectal Cancer from the UK TRACC Part B Study.

Clin Cancer Res. 2024-8-15

[9]
ctDNA as a predictor of outcome after curative resection for locally advanced rectal cancer: systematic review and meta-analysis.

Colorectal Dis. 2024-7

[10]
Minimal Residual Disease using a Plasma-Only Circulating Tumor DNA Assay to Predict Recurrence of Metastatic Colorectal Cancer Following Curative Intent Treatment.

Clin Cancer Res. 2024-7-15

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