Postoperative circulating tumor DNA could guide CRC adjuvant treatment.
et al. Nature medicine 2023 1
Our findings signify a paradigm shift in how we manage patients with CRC after surgery. The GALAXY interim findings show that ctDNA positivity at 4 weeks after surgery is a strong prognostic marker that identifies a group of patients at high risk of both CRC recurrence and decreased DFS. This suggests that ctDNA status might have value as a surrogate end point or marker of treatment efficacy in clinical trials, which has the potential to considerably reduce trial duration and expedite the approval of new therapies in the future.
Molecular residual disease and efficacy of adjuvant chemotherapy in patients with colorectal cancer.
Kotani Daisuke et al. Nature medicine 2023 1
We report results from GALAXY, which is an observational arm of the ongoing CIRCULATE-Japan study (UMIN000039205) that analyzed presurgical and postsurgical ctDNA in patients with stage II–IV resectable CRC (n?=?1,039). In this cohort, with a median follow-up of 16.74 months (range 0.49–24.83 months), postsurgical ctDNA positivity (at 4?weeks after surgery) was associated with higher recurrence risk (hazard ratio (HR) 10.0, P?<?0.0001) and was the most significant prognostic factor associated with recurrence risk in patients with stage II or III CRC (HR 10.82, P?<?0.001).
The Use of Cell-free DNA in Clinical Practice: Work in Progress
M Clyne et al, CDC Blog Post, December 14, 2022
Since its discovery in 1948, the utility of cfDNA has been studied extensively in screening, diagnosis, prognosis, therapy and monitoring disease progression. Although effort has focused on cancer, and mostly in NSCLC, other areas of research are ongoing, including autoimmune disease, metabolic disorders, Alzheimer’s disease, and other neurologic conditions, COVID-19, myocarditis and dilated cardiomyopathy, and refractory epilepsy. In addition to circulating cfDNA, potential clinical applications exist for other omics, including epigenetics and exosomal miRNAs, as well as use of cfDNA in other body fluids (e.g. urine).
Comprehensive pan-cancer genomic landscape of KRAS altered cancers and real-world outcomes in solid tumors.
Lee Jessica K et al. NPJ precision oncology 2022 12 (1) 91
We performed a pan-cancer analysis of KRAS-altered samples from 426,706 adult patients with solid or hematologic malignancies using comprehensive genomic profiling; additional analyses included 62,369 liquid biopsy and 7241 pediatric samples. 23% of adult pan-cancer samples had KRAS alterations; 88% were mutations, most commonly G12D/G12V/G12C/G13D/G12R, and prevalence was similar in liquid biopsies.