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

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 sett...

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Autores principales: Hedtke, Maren, Pessoa Rejas, Rodrigo, Froelich, Matthias F., Ast, Volker, Duda, Angelika, Mirbach, Laura, Costina, Victor, Martens, Uwe M., Hofheinz, Ralf‐Dieter, Neumaier, Michael, Haselmann, Verena
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9120900/
https://www.ncbi.nlm.nih.gov/pubmed/34873826
http://dx.doi.org/10.1002/1878-0261.13156
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author Hedtke, Maren
Pessoa Rejas, Rodrigo
Froelich, Matthias F.
Ast, Volker
Duda, Angelika
Mirbach, Laura
Costina, Victor
Martens, Uwe M.
Hofheinz, Ralf‐Dieter
Neumaier, Michael
Haselmann, Verena
author_facet Hedtke, Maren
Pessoa Rejas, Rodrigo
Froelich, Matthias F.
Ast, Volker
Duda, Angelika
Mirbach, Laura
Costina, Victor
Martens, Uwe M.
Hofheinz, Ralf‐Dieter
Neumaier, Michael
Haselmann, Verena
author_sort Hedtke, Maren
collection PubMed
description 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.
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spelling pubmed-91209002022-05-21 Liquid profiling of circulating tumor DNA in colorectal cancer: steps needed to achieve its full clinical value as standard care Hedtke, Maren Pessoa Rejas, Rodrigo Froelich, Matthias F. Ast, Volker Duda, Angelika Mirbach, Laura Costina, Victor Martens, Uwe M. Hofheinz, Ralf‐Dieter Neumaier, Michael Haselmann, Verena Mol Oncol Research Articles 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. John Wiley and Sons Inc. 2021-12-20 2022-05 /pmc/articles/PMC9120900/ /pubmed/34873826 http://dx.doi.org/10.1002/1878-0261.13156 Text en © 2021 The Authors. Molecular Oncology published by John Wiley & Sons Ltd on behalf of Federation of European Biochemical Societies https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Articles
Hedtke, Maren
Pessoa Rejas, Rodrigo
Froelich, Matthias F.
Ast, Volker
Duda, Angelika
Mirbach, Laura
Costina, Victor
Martens, Uwe M.
Hofheinz, Ralf‐Dieter
Neumaier, Michael
Haselmann, Verena
Liquid profiling of circulating tumor DNA in colorectal cancer: steps needed to achieve its full clinical value as standard care
title Liquid profiling of circulating tumor DNA in colorectal cancer: steps needed to achieve its full clinical value as standard care
title_full Liquid profiling of circulating tumor DNA in colorectal cancer: steps needed to achieve its full clinical value as standard care
title_fullStr Liquid profiling of circulating tumor DNA in colorectal cancer: steps needed to achieve its full clinical value as standard care
title_full_unstemmed Liquid profiling of circulating tumor DNA in colorectal cancer: steps needed to achieve its full clinical value as standard care
title_short Liquid profiling of circulating tumor DNA in colorectal cancer: steps needed to achieve its full clinical value as standard care
title_sort liquid profiling of circulating tumor dna in colorectal cancer: steps needed to achieve its full clinical value as standard care
topic Research Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9120900/
https://www.ncbi.nlm.nih.gov/pubmed/34873826
http://dx.doi.org/10.1002/1878-0261.13156
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