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

Capa

Citar

Texto integral

Acesso aberto Acesso aberto
Acesso é fechado Acesso está concedido
Acesso é fechado Acesso é pago ou somente para assinantes

Resumo

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.

Texto integral

Acesso é fechado

Sobre autores

T. Deshkina

National Medical Research Radiological Center

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

P. Hertsen Moscow Oncology Research Institute

Rússia, Moscow

L. Bolotina

National Medical Research Radiological Center

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

P. Hertsen Moscow Oncology Research Institute

Rússia, Moscow

A. Kornietskaya

National Medical Research Radiological Center

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

P. Hertsen Moscow Oncology Research Institute

Rússia, Moscow

Pavel Golubev

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

Autor responsável pela correspondência
Email: golubev194@gmail.com
ORCID ID: 0000-0003-3532-6476
Código SPIN: 9592-7730

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

Rússia, Moscow

A. Fedenko

National Medical Research Radiological Center

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

P. Hertsen Moscow Oncology Research Institute

Rússia, Moscow

A. Kaprin

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

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

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

Rússia, Moscow; Obninsk; Moscow

Bibliografia

  1. Data source: Globocan 2020 Graph production: Global Cancer Observatory (URL: http://gco.iarc.fr).
  2. Sargent D., Sobrero A., Grothey A., et al. Evidence for cure by adjuvant therapy in colon cancer: observations based on individual patient data from 20,898 patients on 18 randomized trials. J Clin Oncol. 2009;27(6):872–77. doi: 10.1200/JCO.2008.19.5362.
  3. Gray R., Barnwell J., McConkey C., et al.; Quasar Collaborative Group. Adjuvant chemotherapy versus observation in patients with colorectal cancer: a randomised study. Lancet. 2007;370(9604):2020–29. doi: 10.1016/S0140-6736(07)61866-2.
  4. Efficacy of adjuvant fluorouracil and folinic acid in colon cancer. International Multicentre Pooled Analysis of Colon Cancer Trials (IMPACT) investigators. Lancet. 1995;345(8955): 939–44.
  5. Figueredo A., Charette M.L., Maroun J., et al. Adjuvant therapy for stage II colon cancer: a systematic review from the Cancer Care Ontario Program in evidence-based care’s gastrointestinal cancer disease site group. J Clin Oncol. 2004;22(16):3395–407. doi: 10.1200/JCO.2004.03.087.
  6. Argiles G., Tabernero J., Labianca R., et al. Localised Colon Cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up Published in 2020. Ann Oncol. 2020;31(10):1291–1305. doi: 10.1016/j.annonc.2020.06.022.
  7. Bockelman C., Engelmann B.E., Kaprio T., et al. Risk of recurrence in patients with colon cancer stage II and III: a systematic review and meta-analysis of recent literature. Acta Oncol. 2015;54(1):5–16. doi: 10.3109/0284186X.2014.975839.
  8. Dienstmann R., Mason M.J., Sinicrope F.A., et al. Prediction of overall survival in stage II and III colon cancer beyond TNM system: a retrospective, pooled biomarker study. Ann Oncol. 2017;28(5):1023–31. doi: 10.1093/annonc/mdx052.
  9. Bettegowda C., Sausen M., Leary R.J., et al. Detection of circulating tumor DNA in early- and late-stage human malignancies. Sci Transl Med. 2014;6(224):224ra24. doi: 10.1126/scitranslmed.3007094.
  10. Flach S., Howarth K., Hackinger S., et al. Liquid BIOpsy for MiNimal RESidual DiSease Detection in Head and Neck Squamous Cell Carcinoma (LIONESS) – a personalised circulating tumour DNA analysis in head and neck squamous cell carcinoma. Br J Cancer. 2022;126:1186–95. doi: 10.1038/s41416-022-01716-7.
  11. Jun S., Shukla N., Durm G., et al. Analysis of circulating tumor DNA in the phase 2 BTCRC LUN 16-081 trial of consolidation nivolumab with or without ipilimumab after chemoradiation in stage III non–small cell lung cancer. J Clin Oncol. 2022;40(Suppl. 16, abstr. 8534). doi: 10.1200/JCO.2022.40.16_suppl.8534.
  12. Provencio M., Serna-Blasco R., Nadal E., et al. Overall Survival and Biomarker Analysis of Neoadjuvant Nivolumab Plus Chemotherapy in Operable Stage IIIA Non-Small-Cell Lung Cancer (NADIM phase II trial) [published correction appears in J Clin Oncol. 2022;40(32):3785]. J Clin Oncol. 2022;40(25):2924–33. doi: 10.1200/JCO.21.02660.
  13. Lipsyc-Sharf M., De Bruin E., Katheryn S., et al. Circulating tumor DNA (ctDNA) and late recurrence in high-risk, hormone receptor–positive, HER2-negative breast cancer (CHiRP). J Clin Oncol. 2022;40(Suppl. 16):103–103. doi: 10.1200/JCO.2022.40.16_suppl.103.
  14. Bettegowda C., Sausen M., Leary R.J., et al. Detection of circulating tumor DNA in early- and late-stage human malignancies. Sci Transl Med. 2014;6(224):224ra24. doi: 10.1126/scitranslmed.3007094.
  15. Diehn M., Alizadeh A.A., Adams H.-P., et al. Early prediction of clinical outcomes in resected stage II and III colorectal cancer (CRC) through deep sequencing of circulating tumor DNA (ctDNA). J Clin Oncol. 2017;35:3591–1.
  16. Overman M.J., Vauthey J.-N., Aloia T.A., et al. Circulating tumor DNA (ctDNA) utilizing a high-sensitivity panel to detect minimal residual disease post liver hepatectomy and predict disease recurrence. J Clin Oncol. 2017;35:3522–2.
  17. Tie J., Wang Y., Tomasetti C., et al. Circulating tumor DNA analysis detects minimal residual disease and predicts recurrence in patients with stage II colon cancer. Sci Transl Med. 2016;8:346ra92. doi: 10.1126/scitranslmed.aaf6219.
  18. Tie J. C., Cohen J. D., Wang Y., et al. Serial circulating tumor DNA analysis as a prognostic marker and a real-time indicator of adjuvant chemotherapy efficacy in stage III colon cancer. J Clin Oncol. 2018;36(Suppl. 15):3516.
  19. Polyanskaya E.M., Fedyanin M.Yu., Boyarskikh U.A., et al. The prognostic value of circulating in blood tumor DNA as a marker of minimal residual disease in stage I–III colorectal cancer. Adv Mol Oncol. 2022;9(2):32–42. doi: 10.17650/2313-805X-2022-9-2-32-42.
  20. Tie J., Cohen J., Lahouel K. Adjuvant chemotherapy guided by circulating tumor DNA analysis in stage II colon cancer: The randomized DYNAMIC trial. J Clin Oncol. 2022;40(Suppl. 17):LBA100–LBA100. doi: 10.1200/JCO.2022.40.17_suppl.LBA100.
  21. Morris V., Iqbal A. Phase II/III Study of Circulating Tumor DNA as a Predictive Biomarker in Adjuvant Chemotherapy in Patients With Stage IIA Colon Cancer (COBRA): a first-in-kind trial seeks to provide level 1 evidence in evaluating the role of ctDNA as a guide for clinicians in the decision to administer adjuvant chemotherapy to patients with stage IIA colon cancer (NRG GI-005) (NCT04068103). J Clin Oncol. 36(10).
  22. Masahito Kotaka, Hiromichi Shirasu, Jun Watanabe, et al. Association of circulating tumor DNA dynamics with clinical outcomes in the adjuvant setting for patients with colorectal cancer from an observational GALAXY study in CIRCULATE-Japan. J Clin Oncol. 2022;40(Suppl. 4):9–9. doi: 10.1200/JCO.2022.40.4_suppl.009.
  23. Taniguchi H., Nakamura Y., Kotani D., et al. CIRCULATE-Japan: Circulating tumor DNA-guided adaptive platform trials to refine adjuvant therapy for colorectal cancer. Cancer Sci. 2021;112(7):2915–20. doi: 10.1111/cas.14926.

Arquivos suplementares

Arquivos suplementares
Ação
1. JATS XML
Baixar
2. Fig. 1. ESMO Recommendations (2020)

Baixar (195KB)
Metadados
3. Fig. 2. CIRCULATE Japane data platform

Baixar (250KB)
Metadados

Declaração de direitos autorais © Bionika Media, 2024