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Circulating Tumour DNA as Biomarker for Colorectal Liver Metastases: A Systematic Review and Meta-Analysis
Lissa Wullaert1, Jan M van Rees1, John W M Martens2
1Department of Surgical Oncology and Gastrointestinal Surgery, Erasmus MC Cancer Institute, 3015 GD Rotterdam, The Netherlands.
Cells
|November 10, 2023
Summary
Detecting circulating tumor DNA (ctDNA) after colorectal liver metastases (CRLM) treatment indicates a higher risk of recurrence and shorter survival. Pre-treatment ctDNA levels did not show a significant association with outcomes.
Area of Science:
- Oncology
- Molecular Diagnostics
- Personalized Medicine
Background:
- Circulating tumor DNA (ctDNA) is an emerging biomarker for guiding personalized treatment strategies in cancer patients.
- Colorectal liver metastases (CRLM) represent a significant clinical challenge, necessitating accurate prognostic markers for treatment selection.
- The predictive value of ctDNA in CRLM patients undergoing curative-intent local therapy requires comprehensive evaluation.
Approach:
- A systematic literature search was performed on electronic databases for studies published up to May 26, 2023.
- Included studies investigated the association between ctDNA and oncological outcomes (recurrence-free survival and overall survival) in CRLM patients.
- Meta-analyses were conducted to pool hazard ratios (HR) for survival outcomes based on ctDNA detection status.
Key Points:
- Detectable ctDNA post-surgery was significantly associated with a higher recurrence risk (HR 3.12) and shorter overall survival (HR 5.04) in CRLM patients.
- Detectable ctDNA after adjuvant therapy completion also showed a strong association with increased recurrence risk (HR 6.39).
- No significant association was found between pre-surgery ctDNA levels and recurrence-free or overall survival.
Conclusions:
- Post-treatment ctDNA detection is a robust predictor of poor oncological outcomes in patients with CRLM.
- ctDNA analysis after local therapy or adjuvant treatment holds significant prognostic value for CRLM patients.
- These findings support the utility of ctDNA as a biomarker for monitoring treatment response and predicting outcomes in CRLM.
