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Updated: Sep 4, 2025
Detection and Monitoring of Tumor Associated Circulating DNA in Patient Biofluids
Published on: June 8, 2019
Mind the target: circulating tumour DNA in gastrointestinal malignancies
Elisa Fontana1, Ekaterina Ignatova1,2,3
1Sarah Cannon Research Institute UK, London, UK.
Purpose Of Review:
Circulating tumour DNA (ctDNA) is an appealing minimally invasive tool with significant theranostic potential. In this review, we highlighted recent studies evaluating three major applications of ctDNA in gastrointestinal malignancies.
Recent Findings:
ctDNA demonstrated a strong prognostic value in colorectal and gastroesophageal cancers in assessing minimal residual disease after radical surgery. ctDNA-guided interventional studies are ongoing.Tracking clonal dynamics with early identification of response and resistance to therapies is of particular interest in gastrointestinal cancers especially for established targeted therapies such as antiepidermal growth factor receptor (EGFR), BRAF inhibitors and immune checkpoint inhibitors.Early cancer detection via ctDNA approaches is encouraging and of particular relevance in gastrointestinal cancers in view of limited screening programmes and yet poor outcomes of metastatic patients.
Summary:
Although feasible and powerful tool, the clinical utility of ctDNA to guide patients' management is challenging to demonstrate and requires further investigations in large interventional clinical trials.
Insights
Circulating tumor DNA (ctDNA) shows promise for monitoring gastrointestinal cancers, aiding in early detection and treatment response assessment. Further clinical trials are needed to confirm its utility in guiding patient management.
Area of Science:
- Oncology
- Molecular Diagnostics
- Genomics
Background:
- Circulating tumor DNA (ctDNA) is a minimally invasive biomarker with significant theranostic potential.
- Gastrointestinal malignancies represent a major global health burden with limited screening options and poor outcomes for metastatic patients.
Purpose of the Study:
- To review recent studies on the applications of ctDNA in gastrointestinal cancers.
- To highlight the prognostic value, theranostic potential, and early detection capabilities of ctDNA.
Main Methods:
- Literature review of recent studies evaluating ctDNA applications.
- Analysis of ctDNA's role in prognostication, minimal residual disease assessment, and therapy response monitoring.
Main Results:
- ctDNA demonstrates strong prognostic value in colorectal and gastroesophageal cancers for assessing minimal residual disease.
- Tracking clonal dynamics and identifying therapy response/resistance is crucial for targeted therapies (EGFR, BRAF inhibitors, immune checkpoint inhibitors).
- Early cancer detection using ctDNA is encouraging for gastrointestinal cancers.
Conclusions:
- ctDNA is a feasible and powerful tool for gastrointestinal cancer management.
- Clinical utility of ctDNA in guiding patient management requires further validation through large interventional clinical trials.
