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There is a high clinical need for reliable biomarkers that could optimize treatment management in patients with rectal cancer. Researcher Lisa Hofste studied the use of circulating tumor DNA (ctDNA) as a sensitive and minimally-invasive approach to monitor response to treatment in these patients. The study was initiated by Hans de Wilt, Bastiaan Klarenbeek (department of Surgery) and Marjolijn Ligtenberg (department of Human Genetics and department of Pathology) and was published in the European Journal of Surgical Oncology in July 2023.
ctDNA is present in the blood of cancer patients and reflects the presence of tumor somewhere in the body. In this study the value of ctDNA measurements was assessed in patients with early-stage and locally advanced rectal cancer using a tumor-informed ultradeep sequencing approach.
After neoadjuvant treatment ctDNA could not be detected in patients with a clinically complete response who were selected for an active surveillance strategy. This demonstrates the potential of ctDNA measurements to complement current clinical response predictions after neoadjuvant treatment to support the decision for surgery or active surveillance.
Moreover, both ctDNA detection after neoadjuvant treatment and ctDNA detection after surgery were associated with an impaired progression-free survival. Presence of ctDNA could improve assessment of risk of recurrence after surgery which might stratify patients for adjuvant treatment administration. This study emphasizes the clinical validity of ctDNA measurements to optimize treatment decisions.
Read the study here
Hofste LSM, Geerlings MJ, von Rhein D, Rutten H, Westenberg AH, Weiss MM, Gilissen C, Hofste T, van der Post RS, Klarenbeek BR, de Wilt JHW, Ligtenberg MJL. Circulating tumor DNA Detection after Neoadjuvant Treatment and Surgery Predicts Recurrence in Patients with Early-stage and Locally Advanced Rectal Cancer. Eur J Surg Oncol. 2023 Jul;49(7):1283-1290. doi: 10.1016/j.ejso.2023.01.026. Epub 2023 Jan 31. PMID: 36740555.
