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The utility of ctDNA in detecting minimal residual disease following curative surgery in colorectal cancer: a systematic review and meta-analysis.

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posted on 18.11.2022, 11:32 authored by Lucy Faulkner, Lynne Howells, Coral Pepper, Jacqueline Shaw, Anne Thomas

Introduction

Colorectal cancer is the fourth most common cancer in the UK. There remains a need for improved risk stratification following curative resection. Circulating-tumour DNA (ctDNA) has gained particular interest as a cancer biomarker in recent years. We performed a systematic review to assess the utility of ctDNA in identifying minimal residual disease in colorectal cancer.


Methods

Studies were included if ctDNA was measured following curative surgery and long-term outcomes were assessed. Studies were excluded if the manuscript could not be obtained from the British Library or were not available in English.


Results

Thirty-seven studies met the inclusion criteria, involving 3002 patients. Hazard ratios (HRs) for progression-free survival (PFS) were available in 21 studies. A meta-analysis using a random effects model demonstrated poorer PFS associated with ctDNA detection at the first liquid biopsy post-surgery [HR: 6.92 CI: 4.49–10.64 p < 0.00001]. This effect was also seen in subgroup analysis by disease extent, adjuvant chemotherapy and assay type.


Discussion

Here we demonstrate that ctDNA detection post-surgery is associated with a greater propensity to disease relapse and is an independent indicator of poor prognosis. Prior to incorporation into clinical practice, consensus around timing of measurements and assay methodology are critical.

Funding

National Institute of Health Research [ACF-2019-11-008]

Cancer Research UK in conjunction with the UK Department of Health on an Experimental Cancer Medicine Centre grant [C10604/A25151]

History

Author affiliation

Leicester Cancer Research Centre, Department of Genetics and Genome Biology, University of Leicester

Version

VoR (Version of Record)

Published in

British Journal of Cancer

Publisher

Springer Nature [academic journals on nature.com]

issn

0007-0920

Copyright date

2022

Available date

18/11/2022

Language

en

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