Liquid profiling of circulating tumor DNA in colorectal cancer: steps needed to achieve its full clinical value as standard care
The analysis of circulating tumor DNA (ctDNA) is at the threshold of implementation into standard care for colorectal cancer (CRC) patients. However, data about the clinical utility of liquid profiling (LP), its acceptance by clinicians, and its integration into clinical workflows in real‐world sett...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-05-01
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| Series: | Molecular Oncology |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/1878-0261.13156 |
| _version_ | 1811251179685937152 |
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| author | Maren Hedtke Rodrigo Pessoa Rejas Matthias F. Froelich Volker Ast Angelika Duda Laura Mirbach Victor Costina Uwe M. Martens Ralf‐Dieter Hofheinz Michael Neumaier Verena Haselmann |
| author_facet | Maren Hedtke Rodrigo Pessoa Rejas Matthias F. Froelich Volker Ast Angelika Duda Laura Mirbach Victor Costina Uwe M. Martens Ralf‐Dieter Hofheinz Michael Neumaier Verena Haselmann |
| author_sort | Maren Hedtke |
| collection | DOAJ |
| description | The analysis of circulating tumor DNA (ctDNA) is at the threshold of implementation into standard care for colorectal cancer (CRC) patients. However, data about the clinical utility of liquid profiling (LP), its acceptance by clinicians, and its integration into clinical workflows in real‐world settings remain limited. Here, LP tests requested as part of routine care since 2016 were retrospectively evaluated. Results show restrained request behavior that improved moderately over time, as well as reliable diagnostic performance comparable to translational studies, with an overall agreement of 91.7%. Extremely low ctDNA levels at < 0.1% in over 20% of cases, a high frequency of concomitant driver mutations (in up to 14% of cases), and ctDNA levels reflecting the clinical course of disease were revealed. However, certain limitations hampering successful translation of ctDNA into clinical practice were uncovered, including the lack of clinically relevant ctDNA thresholds, appropriate time points of LP requests, and integrative evaluation of ctDNA, imaging, and clinical findings. In conclusion, these results highlight the potential clinical value of LP for CRC patient management and demonstrate issues that need to be addressed for successful long‐term implementation in clinical workflows. |
| first_indexed | 2024-04-12T16:15:40Z |
| format | Article |
| id | doaj.art-c1e5149860064c5e8fd192d932a6be65 |
| institution | Directory Open Access Journal |
| issn | 1574-7891 1878-0261 |
| language | English |
| last_indexed | 2024-04-12T16:15:40Z |
| publishDate | 2022-05-01 |
| publisher | Wiley |
| record_format | Article |
| series | Molecular Oncology |
| spelling | doaj.art-c1e5149860064c5e8fd192d932a6be652022-12-22T03:25:43ZengWileyMolecular Oncology1574-78911878-02612022-05-0116102042205610.1002/1878-0261.13156Liquid profiling of circulating tumor DNA in colorectal cancer: steps needed to achieve its full clinical value as standard careMaren Hedtke0Rodrigo Pessoa Rejas1Matthias F. Froelich2Volker Ast3Angelika Duda4Laura Mirbach5Victor Costina6Uwe M. Martens7Ralf‐Dieter Hofheinz8Michael Neumaier9Verena Haselmann10Institute of Clinical Chemistry Medical Faculty Mannheim of the University of Heidelberg University Hospital Mannheim GermanyInstitute of Clinical Chemistry Medical Faculty Mannheim of the University of Heidelberg University Hospital Mannheim GermanyDepartment of Radiology and Nuclear Medicine University Medicine Mannheim Medical Faculty Mannheim of the University of Heidelberg GermanyInstitute of Clinical Chemistry Medical Faculty Mannheim of the University of Heidelberg University Hospital Mannheim GermanyInstitute of Clinical Chemistry Medical Faculty Mannheim of the University of Heidelberg University Hospital Mannheim GermanyInstitute of Clinical Chemistry Medical Faculty Mannheim of the University of Heidelberg University Hospital Mannheim GermanyInstitute of Clinical Chemistry Medical Faculty Mannheim of the University of Heidelberg University Hospital Mannheim GermanyCancer Center Heilbronn‐Franken SLK‐Clinics MOLIT Institute for Personalized Medicine Heilbronn GermanyDay Treatment Center (TTZ) Interdisciplinary Tumor Center Mannheim (ITM) III Medical Clinic Medical Faculty Mannheim of the University of Heidelberg University Hospital Mannheim GermanyInstitute of Clinical Chemistry Medical Faculty Mannheim of the University of Heidelberg University Hospital Mannheim GermanyInstitute of Clinical Chemistry Medical Faculty Mannheim of the University of Heidelberg University Hospital Mannheim GermanyThe analysis of circulating tumor DNA (ctDNA) is at the threshold of implementation into standard care for colorectal cancer (CRC) patients. However, data about the clinical utility of liquid profiling (LP), its acceptance by clinicians, and its integration into clinical workflows in real‐world settings remain limited. Here, LP tests requested as part of routine care since 2016 were retrospectively evaluated. Results show restrained request behavior that improved moderately over time, as well as reliable diagnostic performance comparable to translational studies, with an overall agreement of 91.7%. Extremely low ctDNA levels at < 0.1% in over 20% of cases, a high frequency of concomitant driver mutations (in up to 14% of cases), and ctDNA levels reflecting the clinical course of disease were revealed. However, certain limitations hampering successful translation of ctDNA into clinical practice were uncovered, including the lack of clinically relevant ctDNA thresholds, appropriate time points of LP requests, and integrative evaluation of ctDNA, imaging, and clinical findings. In conclusion, these results highlight the potential clinical value of LP for CRC patient management and demonstrate issues that need to be addressed for successful long‐term implementation in clinical workflows.https://doi.org/10.1002/1878-0261.13156colorectal cancerctDNAliquid biopsyliquid profilingreal‐world |
| spellingShingle | Maren Hedtke Rodrigo Pessoa Rejas Matthias F. Froelich Volker Ast Angelika Duda Laura Mirbach Victor Costina Uwe M. Martens Ralf‐Dieter Hofheinz Michael Neumaier Verena Haselmann Liquid profiling of circulating tumor DNA in colorectal cancer: steps needed to achieve its full clinical value as standard care Molecular Oncology colorectal cancer ctDNA liquid biopsy liquid profiling real‐world |
| title | Liquid profiling of circulating tumor DNA in colorectal cancer: steps needed to achieve its full clinical value as standard care |
| title_full | Liquid profiling of circulating tumor DNA in colorectal cancer: steps needed to achieve its full clinical value as standard care |
| title_fullStr | Liquid profiling of circulating tumor DNA in colorectal cancer: steps needed to achieve its full clinical value as standard care |
| title_full_unstemmed | Liquid profiling of circulating tumor DNA in colorectal cancer: steps needed to achieve its full clinical value as standard care |
| title_short | Liquid profiling of circulating tumor DNA in colorectal cancer: steps needed to achieve its full clinical value as standard care |
| title_sort | liquid profiling of circulating tumor dna in colorectal cancer steps needed to achieve its full clinical value as standard care |
| topic | colorectal cancer ctDNA liquid biopsy liquid profiling real‐world |
| url | https://doi.org/10.1002/1878-0261.13156 |
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