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Detection and Monitoring of Tumor Associated Circulating DNA in Patient Biofluids
Published on: June 8, 2019
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Circulating tumor DNA use in a community oncology practice
Erin D Chamberlain1, Carrie L Costantini1, Marin F Xavier1
1Scripps Hillcrest Oncology Clinic, San Diego, CA, USA.
Translational Cancer Research
|February 4, 2022
Summary
Comprehensive genomic profiling (CGP) of circulating tumor DNA (ctDNA) in advanced solid tumors influenced treatment in only 42% of patients, highlighting a gap between genomic data and targeted therapy. Further research is needed to optimize ctDNA utilization in community oncology.
Area of Science:
- Oncology
- Genomics
- Molecular Diagnostics
Background:
- Retrospective study evaluating circulating tumor DNA (ctDNA) comprehensive genomic profiling (CGP) in a community oncology setting.
- Focus on patients with advanced solid tumors.
Purpose of the Study:
- To describe the utilization of ctDNA CGP in community practice.
- To assess the impact of ctDNA CGP on therapeutic decision-making for advanced solid tumors.
Main Methods:
- Single-center retrospective study of patients at Scripps Hillcrest Oncology Clinic (September 2016 - March 2018).
- Inclusion of patients with advanced solid tumors who underwent ctDNA assay testing for therapeutic decision-making.
- Analysis of diverse tumor types and lines of therapy.
Main Results:
- ctDNA CGP results influenced therapeutic actions in 42% of 41 patients.
- Influenced actions included initiating FDA-approved or off-label therapies and clinical trial enrollment.
- CGP guided avoidance of futile treatments (e.g., EGFR inhibition in KRAS-mutated colorectal cancer).
- No additional prognostic or therapeutic information was obtained in 25% of cases.
- Therapeutic action was not influenced by ctDNA results in 58% of cases.
Conclusions:
- Genomic information from ctDNA does not consistently translate to meaningful targeted therapy in advanced solid tumors.
- Further studies are necessary to guide community oncologists in utilizing ctDNA results for treatment selection.
- The evolving landscape of targeted therapy, immunotherapy, and chemotherapy necessitates optimized ctDNA utilization strategies.
