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Circulating tumor DNA – A potential aid in the management of chordomas

Chordomas are a locally invasive, low-grade, CNS malignancy that are primarily found in the skull base, spine, and sacrum. They are thought to be derived from notochordal remnants and remain a significant clinical challenge due to their local invasiveness, resistance to chemoradiation, and difficult...

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Autores principales: Frederico, Stephen C., Darling, Corbin, Zhang, Xiaoran, Huq, Sakibul, Agnihotri, Sameer, Gardner, Paul A., Snyderman, Carl H., Wang, Eric W., Zenonos, Georgios A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9632974/
https://www.ncbi.nlm.nih.gov/pubmed/36338734
http://dx.doi.org/10.3389/fonc.2022.1016385
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author Frederico, Stephen C.
Darling, Corbin
Zhang, Xiaoran
Huq, Sakibul
Agnihotri, Sameer
Gardner, Paul A.
Snyderman, Carl H.
Wang, Eric W.
Zenonos, Georgios A.
author_facet Frederico, Stephen C.
Darling, Corbin
Zhang, Xiaoran
Huq, Sakibul
Agnihotri, Sameer
Gardner, Paul A.
Snyderman, Carl H.
Wang, Eric W.
Zenonos, Georgios A.
author_sort Frederico, Stephen C.
collection PubMed
description Chordomas are a locally invasive, low-grade, CNS malignancy that are primarily found in the skull base, spine, and sacrum. They are thought to be derived from notochordal remnants and remain a significant clinical challenge due to their local invasiveness, resistance to chemoradiation, and difficulty in achieving a complete resection. Adjuvant therapy such as proton beam therapy is critical in preventing recurrence in patients who are at high risk, however this treatment is associated with increased risk of complication. Currently, intraoperative observation and imaging findings are used to determine recurrence and success of gross total resection. These methods can be unreliable due to limited operative view, bony and soft tissue involvement, and complex post-operative changes on MRI. Earlier detection of incomplete resection or recurrence will allow for earlier ability to intervene and potentially improve patient outcomes. Circulating-tumor DNA (ctDNA) is cell-free DNA that is released by tumor cells as they undergo cellular turn-over. Monitoring ctDNA has been shown to be more sensitive at predicting residual tumor than imaging in numerous solid malignancies. Furthermore, ctDNA could be detected earlier in peripheral blood as opposed to imaging changes, allowing for earlier intervention. In this review, we intend to give a brief overview of the current state of molecular diagnosis for skull base chordomas. We will then discuss current advances in the utilization of ctDNA for the management of CNS pathologies such as glioblastoma (GBM) and brain metastases. We will also discuss the role ctDNA has in the management of non-CNS pathologies such as osteosarcoma and Ewing sarcoma (EWS). Finally, we will discuss potential implications of ctDNA monitoring for chordoma management.
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spelling pubmed-96329742022-11-04 Circulating tumor DNA – A potential aid in the management of chordomas Frederico, Stephen C. Darling, Corbin Zhang, Xiaoran Huq, Sakibul Agnihotri, Sameer Gardner, Paul A. Snyderman, Carl H. Wang, Eric W. Zenonos, Georgios A. Front Oncol Oncology Chordomas are a locally invasive, low-grade, CNS malignancy that are primarily found in the skull base, spine, and sacrum. They are thought to be derived from notochordal remnants and remain a significant clinical challenge due to their local invasiveness, resistance to chemoradiation, and difficulty in achieving a complete resection. Adjuvant therapy such as proton beam therapy is critical in preventing recurrence in patients who are at high risk, however this treatment is associated with increased risk of complication. Currently, intraoperative observation and imaging findings are used to determine recurrence and success of gross total resection. These methods can be unreliable due to limited operative view, bony and soft tissue involvement, and complex post-operative changes on MRI. Earlier detection of incomplete resection or recurrence will allow for earlier ability to intervene and potentially improve patient outcomes. Circulating-tumor DNA (ctDNA) is cell-free DNA that is released by tumor cells as they undergo cellular turn-over. Monitoring ctDNA has been shown to be more sensitive at predicting residual tumor than imaging in numerous solid malignancies. Furthermore, ctDNA could be detected earlier in peripheral blood as opposed to imaging changes, allowing for earlier intervention. In this review, we intend to give a brief overview of the current state of molecular diagnosis for skull base chordomas. We will then discuss current advances in the utilization of ctDNA for the management of CNS pathologies such as glioblastoma (GBM) and brain metastases. We will also discuss the role ctDNA has in the management of non-CNS pathologies such as osteosarcoma and Ewing sarcoma (EWS). Finally, we will discuss potential implications of ctDNA monitoring for chordoma management. Frontiers Media S.A. 2022-10-20 /pmc/articles/PMC9632974/ /pubmed/36338734 http://dx.doi.org/10.3389/fonc.2022.1016385 Text en Copyright © 2022 Frederico, Darling, Zhang, Huq, Agnihotri, Gardner, Snyderman, Wang and Zenonos https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Frederico, Stephen C.
Darling, Corbin
Zhang, Xiaoran
Huq, Sakibul
Agnihotri, Sameer
Gardner, Paul A.
Snyderman, Carl H.
Wang, Eric W.
Zenonos, Georgios A.
Circulating tumor DNA – A potential aid in the management of chordomas
title Circulating tumor DNA – A potential aid in the management of chordomas
title_full Circulating tumor DNA – A potential aid in the management of chordomas
title_fullStr Circulating tumor DNA – A potential aid in the management of chordomas
title_full_unstemmed Circulating tumor DNA – A potential aid in the management of chordomas
title_short Circulating tumor DNA – A potential aid in the management of chordomas
title_sort circulating tumor dna – a potential aid in the management of chordomas
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9632974/
https://www.ncbi.nlm.nih.gov/pubmed/36338734
http://dx.doi.org/10.3389/fonc.2022.1016385
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