Using Circulating Tumor DNA in Colorectal Cancer: Current and Evolving Practices.

Area of Science:

• Oncology
• Molecular Diagnostics
• Genomics

Background:

• Colorectal cancer (CRC) management requires effective biomarkers for risk stratification.
• Circulating tumor DNA (ctDNA) shows promise as a prognostic and predictive biomarker.
• CRC is well-suited for liquid biopsy due to significant shedding of tumor DNA fragments.

Purpose of the Study:

• To review the current and evolving applications of ctDNA in colorectal cancer.
• To highlight ctDNA's role in personalized management and clinical decision-making.
• To discuss various ctDNA liquid biopsy platforms and their clinical utility.

Main Methods:

• Review of existing literature and ongoing prospective studies (e.g., CIRCULATE, COBRA, Dynamic II/III, ACT3).
• Analysis of ctDNA applications including minimal residual disease (MRD) detection, recurrence monitoring, and therapeutic response prediction.
• Examination of tumor-informed and tumor-agnostic ctDNA platforms.

Main Results:

• ctDNA has expanded utility from advanced disease profiling to MRD detection and early diagnosis.
• Prospective studies are investigating ctDNA's role in guiding CRC patient management.
• Different ctDNA platforms possess distinct advantages and disadvantages for specific clinical scenarios.

Conclusions:

• ctDNA is a valuable tool for prognostic and predictive biomarker discovery in colorectal cancer.
• Further research and prospective studies are crucial to define ctDNA's optimal clinical integration.
• Understanding diverse ctDNA liquid biopsy platforms is essential for effective application in CRC.