Liquid profiling of circulating tumor DNA in colorectal cancer: steps needed to achieve its full clinical value as standard care

Molecular Oncology

Uwe M. Martens¹  Ralf‐Dieter Hofheinz²  Matthias F. Froelich³  Maren Hedtke⁴  Verena Haselmann⁴  Victor Costina⁴  Volker Ast⁴  Angelika Duda⁴  Michael Neumaier⁴  Laura Mirbach⁴  Rodrigo Pessoa Rejas⁴ 

[1] Cancer Center Heilbronn‐Franken SLK‐Clinics MOLIT Institute for Personalized Medicine Heilbronn Germany;Day Treatment Center (TTZ) Interdisciplinary Tumor Center Mannheim (ITM) III Medical Clinic Medical Faculty Mannheim of the University of Heidelberg University Hospital Mannheim Germany;Department of Radiology and Nuclear Medicine University Medicine Mannheim Medical Faculty Mannheim of the University of Heidelberg Germany;Institute of Clinical Chemistry Medical Faculty Mannheim of the University of Heidelberg University Hospital Mannheim Germany;

关键词: colorectal cancer;    ctDNA;    liquid biopsy;    liquid profiling;    real‐world;   

DOI  :  10.1002/1878-0261.13156

来源: DOAJ

【 摘 要 】

The analysis of circulating tumor DNA (ctDNA) is at the threshold of implementation into standard care for colorectal cancer (CRC) patients. However, data about the clinical utility of liquid profiling (LP), its acceptance by clinicians, and its integration into clinical workflows in real‐world settings remain limited. Here, LP tests requested as part of routine care since 2016 were retrospectively evaluated. Results show restrained request behavior that improved moderately over time, as well as reliable diagnostic performance comparable to translational studies, with an overall agreement of 91.7%. Extremely low ctDNA levels at < 0.1% in over 20% of cases, a high frequency of concomitant driver mutations (in up to 14% of cases), and ctDNA levels reflecting the clinical course of disease were revealed. However, certain limitations hampering successful translation of ctDNA into clinical practice were uncovered, including the lack of clinically relevant ctDNA thresholds, appropriate time points of LP requests, and integrative evaluation of ctDNA, imaging, and clinical findings. In conclusion, these results highlight the potential clinical value of LP for CRC patient management and demonstrate issues that need to be addressed for successful long‐term implementation in clinical workflows.

【 授权许可】

Unknown