Circulating tumor DNA testing may aid in adjuvant therapy decisions for colorectal cancer
Click Here to Manage Email Alerts
Circulating tumor DNA testing appeared to identify risk for recurrence among patients with stage II to stage IV colorectal cancer, according to study results published in Nature Medicine.
Moreover, circulating tumor DNA (ctDNA) testing identified which patients may benefit from adjuvant chemotherapy, researchers noted.
Rationale and methods
More than 30% of patients with resectable colorectal cancer experience relapse despite standard-of-care treatment, according to study background.
However, ctDNA testing may aid in postsurgical risk stratification and adjuvant chemotherapy treatment decision-making, researchers wrote.
The prospective observational GALAXY study — part of the ongoing CIRCULATE-Japan trial — included 1,039 patients with stage II to stage IV resectable colorectal cancer monitored for recurrence with a molecular residual disease (MRD) test (Signatera, Natera).
Median follow-up was 16.74 months.
Findings
Results showed ctDNA positivity at 4 weeks after surgery appeared associated with increased risk for recurrence (HR = 10; P< .0001).
Researchers identified postsurgical ctDNA positivity as the most significant prognostic factor associated with risk for colorectal cancer recurrence among all patients (HR = 10.82; P < .001).
Moreover, postsurgical ctDNA positivity identified those with stage II or stage III colorectal cancer who could most likely derive benefit from treatment with adjuvant chemotherapy (HR = 6.59; P < .0001).
Implications
“Until now, oncologists did not have adequate tools to determine which [patients with colorectal cancer] are likely to benefit from adjuvant systemic therapy,” Takayuki Yoshino, MD, PhD, director for the department of gastroenterology and gastrointestinal oncology at National Cancer Center Hospital East, said in a press release. “This study provides strong evidence that Signatera MRD-positive patients will benefit significantly from adjuvant therapy, while MRD-negative patients may be safely observed, regardless of clinical or pathological stage.”
References:
- Kotani D, et al. Nat Med. 2023;doi:10.1038/s41591-022-02115-4.
- Natera announces publication of prospective, multi-site CIRCULATE study in Nature Medicine demonstrating Signatera’s ability to predict chemotherapy benefit in colorectal cancer (press release). Available at: www.businesswire.com/news/home/20230117005509/en/Natera-Announces-Publication-of-Prospective-Multi-Site-CIRCULATE-Study-in-Nature-Medicine-Demonstrating-Signatera. Published Jan. 17, 2023. Accessed Jan. 19, 2023.
Perspective
Back to Top
Sanjay Reddy, MD, FACS
The role of liquid biopsies in cancer care points us in the direction of personalized medicine. Using blood samples, and identifying circulating tumor cells, is a sensitive way to detect “rogue” cancer cells that may not otherwise have been detected with traditional blood tests or imaging modalities. The true benefit of liquid biopsies is that we have the opportunity to de-escalate care for certain patients deemed low risk, who would have otherwise received chemotherapy.
Collapse
Read more about
Click Here to Manage Email Alerts