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Related Experiment Video

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Clinical value of sequential circulating tumor DNA analysis using next-generation sequencing and epigenetic

Tom Boeken1, Olivier Pellerin2, Camille Bourreau3

  • 1Department of Vascular and Oncological Interventional Radiology, AP-HP, INSERM PARCC U 970, Hôpital Européen Georges Pompidou, HEKA INRIA, Université de Paris Cité, Paris, France. tom.boeken@aphp.fr.

La Radiologia Medica
|August 25, 2024
PubMed
Summary
This summary is machine-generated.

Routine testing of circulating tumor DNA (ctDNA) before and after thermal ablation is feasible for colorectal cancer patients. Detecting ctDNA can help identify patients likely to benefit from this cancer treatment.

Keywords:
Circulating tumor DNA (ctDNA)Colorectal cancerNext-generation sequencing (NGS)Prognostic valueThermal ablation

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Area of Science:

  • Oncology
  • Molecular Diagnostics

Background:

  • Thermal ablation is a standard treatment for oligometastatic colorectal cancer, but patient selection remains a challenge.
  • Routine testing of circulating tumor DNA (ctDNA) before and after thermal ablation is a novel approach to improve patient selection.

Purpose of the Study:

  • To assess the feasibility of routine ctDNA testing using next-generation sequencing (NGS) and methylation-specific digital droplet PCR (ddPCR) before and after thermal ablation.
  • To evaluate the prognostic value of pre-ablation ctDNA for predicting recurrence-free survival in colorectal cancer patients.

Main Methods:

  • A single-center prospective study involving 15 colorectal cancer patients undergoing curative-intent thermal ablation.
  • Cell-free DNA was analyzed using NGS and ddPCR for WIF1 and NPY gene hypermethylation at multiple time points.
  • ctDNA positivity was defined by the presence of tumor mutation or hypermethylation; recurrence-free survival was the primary endpoint.

Main Results:

  • 15 patients and 60 samples were analyzed, with a median follow-up of 316 days and median recurrence-free survival of 250 days.
  • ctDNA was detected in 33% of samples within 24 hours post-ablation.
  • Baseline ctDNA presence was associated with a significantly lower risk of progression (Hazard Ratio = 0.14, p=0.019). Patients without recurrence were ctDNA-negative at 24 hours post-ablation.

Conclusions:

  • Routine ctDNA testing before and after thermal ablation is feasible in colorectal cancer patients, even with low tumor burden.
  • ctDNA detection using NGS and ddPCR shows prognostic value, aiding in the selection of patients who will benefit from thermal ablation.
  • Further research and larger studies are warranted to confirm these findings and refine patient selection strategies.