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Post-operative ctDNA monitoring in stage I colon cancer: A case report

Circulating tumor DNA (ctDNA) level monitoring after surgery for colon cancer has been studied in stage II and III colon cancer to risk-stratify patients for adjuvant therapy. However, there is less data regarding the role of this diagnostic tool in the management of stage I disease, where current r...

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Autores principales: Alden, Stephanie L., Dhani, Harmeet, Palsuledesai, Charuta C., Krinshpun, Shifra, Jurdi, Adham, Christenson, Eric, Browner, Ilene, Rosner, Samuel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9795219/
https://www.ncbi.nlm.nih.gov/pubmed/36591529
http://dx.doi.org/10.3389/fonc.2022.1074786
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author Alden, Stephanie L.
Dhani, Harmeet
Palsuledesai, Charuta C.
Krinshpun, Shifra
Jurdi, Adham
Christenson, Eric
Browner, Ilene
Rosner, Samuel
author_facet Alden, Stephanie L.
Dhani, Harmeet
Palsuledesai, Charuta C.
Krinshpun, Shifra
Jurdi, Adham
Christenson, Eric
Browner, Ilene
Rosner, Samuel
author_sort Alden, Stephanie L.
collection PubMed
description Circulating tumor DNA (ctDNA) level monitoring after surgery for colon cancer has been studied in stage II and III colon cancer to risk-stratify patients for adjuvant therapy. However, there is less data regarding the role of this diagnostic tool in the management of stage I disease, where current recommended surveillance is limited to screening colonoscopy at one year. In this report, we describe the case of a 57-year-old man with stage I colon cancer who underwent complete resection with adequate lymph node surgical sampling, normal preoperative CEA and no evidence of metastatic disease on initial imaging. The patient elected to undergo serial ctDNA monitoring after surgery. Rising ctDNA levels, five months after resection, prompted cross-sectional imaging which demonstrated metastatic disease to the liver. The patient subsequently received five cycles of leucovorin, 5-fluorouracil, oxaliplatin, and irinotecan with bevacizumab (FOLFOXIRI-Bev) and definitive microwave ablation to the liver metastases, with resulting undetectable ctDNA levels. The patient’s imaging and colonoscopy one-year post-operatively showed no evidence of disease, with ctDNA levels remaining undetectable. This report highlights the value of ctDNA monitoring in patients with early-stage colon cancer and suggests that further, large-scale studies may be warranted to determine its appropriate clinical use.
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spelling pubmed-97952192022-12-29 Post-operative ctDNA monitoring in stage I colon cancer: A case report Alden, Stephanie L. Dhani, Harmeet Palsuledesai, Charuta C. Krinshpun, Shifra Jurdi, Adham Christenson, Eric Browner, Ilene Rosner, Samuel Front Oncol Oncology Circulating tumor DNA (ctDNA) level monitoring after surgery for colon cancer has been studied in stage II and III colon cancer to risk-stratify patients for adjuvant therapy. However, there is less data regarding the role of this diagnostic tool in the management of stage I disease, where current recommended surveillance is limited to screening colonoscopy at one year. In this report, we describe the case of a 57-year-old man with stage I colon cancer who underwent complete resection with adequate lymph node surgical sampling, normal preoperative CEA and no evidence of metastatic disease on initial imaging. The patient elected to undergo serial ctDNA monitoring after surgery. Rising ctDNA levels, five months after resection, prompted cross-sectional imaging which demonstrated metastatic disease to the liver. The patient subsequently received five cycles of leucovorin, 5-fluorouracil, oxaliplatin, and irinotecan with bevacizumab (FOLFOXIRI-Bev) and definitive microwave ablation to the liver metastases, with resulting undetectable ctDNA levels. The patient’s imaging and colonoscopy one-year post-operatively showed no evidence of disease, with ctDNA levels remaining undetectable. This report highlights the value of ctDNA monitoring in patients with early-stage colon cancer and suggests that further, large-scale studies may be warranted to determine its appropriate clinical use. Frontiers Media S.A. 2022-12-14 /pmc/articles/PMC9795219/ /pubmed/36591529 http://dx.doi.org/10.3389/fonc.2022.1074786 Text en Copyright © 2022 Alden, Dhani, Palsuledesai, Krinshpun, Jurdi, Christenson, Browner and Rosner 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
Alden, Stephanie L.
Dhani, Harmeet
Palsuledesai, Charuta C.
Krinshpun, Shifra
Jurdi, Adham
Christenson, Eric
Browner, Ilene
Rosner, Samuel
Post-operative ctDNA monitoring in stage I colon cancer: A case report
title Post-operative ctDNA monitoring in stage I colon cancer: A case report
title_full Post-operative ctDNA monitoring in stage I colon cancer: A case report
title_fullStr Post-operative ctDNA monitoring in stage I colon cancer: A case report
title_full_unstemmed Post-operative ctDNA monitoring in stage I colon cancer: A case report
title_short Post-operative ctDNA monitoring in stage I colon cancer: A case report
title_sort post-operative ctdna monitoring in stage i colon cancer: a case report
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9795219/
https://www.ncbi.nlm.nih.gov/pubmed/36591529
http://dx.doi.org/10.3389/fonc.2022.1074786
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