Evaluation of Molecular Residual Disease by a Fixed Panel in Resectable Colorectal Cancer

Jian Yang ¹, Chengqing Yu ¹, Haoran Li ¹

⁰Department of General Surgery, The First Affiliated Hospital of Soochow University, Jiangsu, China.

Cancer Research and Treatment +

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May 10, 2024

View abstract on PubMed

Summary

A fixed-panel assay for detecting circulating tumor DNA (ctDNA) in colorectal cancer (CRC) patients on postoperative day 7 shows significant prognostic value for disease-free survival. This tumor-informed fixed panel may offer a cost-effective approach for monitoring molecular residual disease (MRD) in CRC.

Area Of Science

Oncology
Molecular Biology
Cancer Biomarkers

Background

Molecular residual disease (MRD) is a key prognostic biomarker in colorectal cancer (CRC).
Whole-exome sequencing (WES)-based tumor-informed assays are standard for MRD detection using circulating tumor DNA (ctDNA).
Assessing the feasibility of fixed-panel assays for MRD evaluation in CRC is crucial for clinical application.

Purpose Of The Study

To evaluate the feasibility of a fixed-panel assay for MRD detection in colorectal cancer (CRC).
To compare the performance of fixed-panel assays against personalized assays for ctDNA evaluation.
To determine the prognostic value of ctDNA positivity for disease-free survival (DFS) in CRC patients.

Main Methods

Seventy-five patients with resectable stage I-III CRC were enrolled.
Tumor tissues and serial blood samples (preoperative and postoperative day 7) were collected.
ctDNA was analyzed using tumor-agnostic/informed fixed assays and WES-based/panel-based personalized assays.

Main Results

The tumor-informed fixed assay demonstrated a higher preoperative positive rate (73.3%) than the tumor-agnostic assay (57.3%).
Postoperative day 7 ctDNA positivity by the tumor-informed fixed assay significantly predicted worse DFS (HR, 20.74; p < 0.001) and was an independent predictor.
Personalized assays and the tumor-informed fixed assay showed similar prognostic performance for DFS, outperforming the tumor-agnostic fixed panel.

Conclusions

The study confirms the prognostic significance of ctDNA positivity on postoperative day 7 using a tumor-informed fixed panel in CRC.
The tumor-informed fixed panel emerges as a potentially cost-effective method for MRD evaluation in CRC.
Further research is warranted to validate the clinical utility of the tumor-informed fixed panel for MRD monitoring.

Keywords:

Circulating tumor DNA Fixed panel High-throughput nucleotide sequencing Molecular residual disease Personalized panel Tumor-agnostic Tumor-informed