Possibility of de-escalation of adjuvant chemotherapy in patients with colorectal cancer taking into account the ctDNA determination

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Abstract

Background. The role of adjuvant chemotherapy in patients with stage IIA colorectal cancer (CRC) remains questionable, since this treatment strategy does not lead to an increase in overall survival. However, if at least one unfavorable prognosis factor is present, postoperative chemotherapy is still recommended. Currently, the global oncology community recognizes that this approach is not reliable and has a low level of evidence. Thus, the search for new predictive factors that can become a reliable tool when deciding whether to prescribe or refuse adjuvant chemotherapy continues. Determination of circulating tumor DNA (ctDNA) is one of the most promising areas. The article presents current literature data on the possibility and feasibility of determining ctDNA in patients with stage IIA colorectal cancer, which will allow optimizing postoperative treatment tactics.

Conclusion. Today, the ctDNA determination has become an important prognostic marker, which in the future can influence the management strategy of cancer patients both in the direction of escalation and de-escalation of treatment, protect some patients from overtreatment and, conversely, accurately select patients for more intensive treatment options.

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About the authors

T. I. Deshkina

National Medical Research Radiological Center

Email: golubev194@gmail.com
ORCID iD: 0000-0002-3371-7548
SPIN-code: 5950-5474

P. Hertsen Moscow Oncology Research Institute

Russian Federation, Moscow

L. V. Bolotina

National Medical Research Radiological Center

Email: golubev194@gmail.com
ORCID iD: 0000-0003-4879-2687
SPIN-code: 2787-5414

P. Hertsen Moscow Oncology Research Institute

Russian Federation, Moscow

A. L. Kornietskaya

National Medical Research Radiological Center

Email: golubev194@gmail.com
ORCID iD: 0000-0003-0092-0459
SPIN-code: 2651-7158

P. Hertsen Moscow Oncology Research Institute

Russian Federation, Moscow

Pavel V. Golubev

Moscow City Hospital n.a. S.S. Yudin of the Moscow Healthcare Department

Author for correspondence.
Email: golubev194@gmail.com
ORCID iD: 0000-0003-3532-6476
SPIN-code: 9592-7730

Cand. Sci. (Med.), Oncologist, Chemotherapy Department No. 2 of the Oncology Center No. 1

Russian Federation, Moscow

A. A. Fedenko

National Medical Research Radiological Center

Email: golubev194@gmail.com
ORCID iD: 0000-0003-4927-5585
SPIN-code: 9847-7668

P. Hertsen Moscow Oncology Research Institute

Russian Federation, Moscow

A. D. Kaprin

National Medical Research Radiological Center; National Medical Research Radiological Center; RUDN University

Email: golubev194@gmail.com
ORCID iD: 0000-0001-8784-8415
SPIN-code: 1759-8101

P. Hertsen Moscow Oncology Research Institute – Branch of the National Medical Research Radiological Center

Russian Federation, Moscow; Obninsk; Moscow

References

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