Research ArticleCancer

Circulating tumor DNA analysis detects minimal residual disease and predicts recurrence in patients with stage II colon cancer

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Science Translational Medicine  06 Jul 2016:
Vol. 8, Issue 346, pp. 346ra92
DOI: 10.1126/scitranslmed.aaf6219

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  • The use of circulating tumour DNA in colorectal cancer

    We read with interest the article by Tie et al entitled " Circulating tumour DNA analysis detects minimal residual disease and predicts recurrence in patients with stage II colon cancer"(1).

    Biomarkers in colorectal cancer (CRC) have had limited success to date, with only a few markers such as KRAS, BRAF, CEA and MSI having clinical relevance, with majority of novel biomarkers remaining in the domain of experimental research.

    However, this study by Tie et al was able to show on multivariate analysis that ctDNA status was associated with risk of recurrence (p < 0.001), and that ctDNA was a more reliable marker of recurrence as part of a surveillance program post curative resection for stage II colon cancer than CEA.

    This study was not able to show an association between ctDNA and conventional high-risk clinicopathologic factors. This was likely due to the fact that the majority of the patients in this study were ctDNA negative.

    Keeping in mind that stage II colon cancers without adverse features have an excellent prognosis with low recurrence rates, and there is little (if any) benefit in adjuvant chemotherapy in this group, perhaps further research on ctDNA in stage II CRCs could just focus on high risk stage II with adverse features. This may limit the number of negative results and justify its applicability - targeting a potential role of ctDNA testing.

    Does ctDNA status in high risk stage II colon cancers with adverse f...

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    Competing Interests: None declared.

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