Circulating tumor DNA – A potential aid in the management of chordomas
Chordomas are a locally invasive, low-grade, CNS malignancy that are primarily found in the skull base, spine, and sacrum. They are thought to be derived from notochordal remnants and remain a significant clinical challenge due to their local invasiveness, resistance to chemoradiation, and difficult...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-10-01
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| Series: | Frontiers in Oncology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2022.1016385/full |
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| author | Stephen C. Frederico Stephen C. Frederico Corbin Darling Corbin Darling Xiaoran Zhang Sakibul Huq Sameer Agnihotri Paul A. Gardner Carl H. Snyderman Carl H. Snyderman Eric W. Wang Georgios A. Zenonos |
| author_facet | Stephen C. Frederico Stephen C. Frederico Corbin Darling Corbin Darling Xiaoran Zhang Sakibul Huq Sameer Agnihotri Paul A. Gardner Carl H. Snyderman Carl H. Snyderman Eric W. Wang Georgios A. Zenonos |
| author_sort | Stephen C. Frederico |
| collection | DOAJ |
| description | Chordomas are a locally invasive, low-grade, CNS malignancy that are primarily found in the skull base, spine, and sacrum. They are thought to be derived from notochordal remnants and remain a significant clinical challenge due to their local invasiveness, resistance to chemoradiation, and difficulty in achieving a complete resection. Adjuvant therapy such as proton beam therapy is critical in preventing recurrence in patients who are at high risk, however this treatment is associated with increased risk of complication. Currently, intraoperative observation and imaging findings are used to determine recurrence and success of gross total resection. These methods can be unreliable due to limited operative view, bony and soft tissue involvement, and complex post-operative changes on MRI. Earlier detection of incomplete resection or recurrence will allow for earlier ability to intervene and potentially improve patient outcomes. Circulating-tumor DNA (ctDNA) is cell-free DNA that is released by tumor cells as they undergo cellular turn-over. Monitoring ctDNA has been shown to be more sensitive at predicting residual tumor than imaging in numerous solid malignancies. Furthermore, ctDNA could be detected earlier in peripheral blood as opposed to imaging changes, allowing for earlier intervention. In this review, we intend to give a brief overview of the current state of molecular diagnosis for skull base chordomas. We will then discuss current advances in the utilization of ctDNA for the management of CNS pathologies such as glioblastoma (GBM) and brain metastases. We will also discuss the role ctDNA has in the management of non-CNS pathologies such as osteosarcoma and Ewing sarcoma (EWS). Finally, we will discuss potential implications of ctDNA monitoring for chordoma management. |
| first_indexed | 2024-04-13T18:43:04Z |
| format | Article |
| id | doaj.art-e973ba811cf14695b673db241e7e2d51 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-04-13T18:43:04Z |
| publishDate | 2022-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-e973ba811cf14695b673db241e7e2d512022-12-22T02:34:40ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2022-10-011210.3389/fonc.2022.10163851016385Circulating tumor DNA – A potential aid in the management of chordomasStephen C. Frederico0Stephen C. Frederico1Corbin Darling2Corbin Darling3Xiaoran Zhang4Sakibul Huq5Sameer Agnihotri6Paul A. Gardner7Carl H. Snyderman8Carl H. Snyderman9Eric W. Wang10Georgios A. Zenonos11School of Medicine, University of Pittsburgh, Pittsburgh, PA, United StatesDepartment of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, United StatesSchool of Medicine, University of Pittsburgh, Pittsburgh, PA, United StatesDepartment of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, United StatesDepartment of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, United StatesDepartment of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, United StatesDepartment of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, United StatesDepartment of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, United StatesDepartment of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, United StatesDepartment of Otolaryngology, University of Pittsburgh, Pittsburgh, PA, United StatesDepartment of Otolaryngology, University of Pittsburgh, Pittsburgh, PA, United StatesDepartment of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, United StatesChordomas are a locally invasive, low-grade, CNS malignancy that are primarily found in the skull base, spine, and sacrum. They are thought to be derived from notochordal remnants and remain a significant clinical challenge due to their local invasiveness, resistance to chemoradiation, and difficulty in achieving a complete resection. Adjuvant therapy such as proton beam therapy is critical in preventing recurrence in patients who are at high risk, however this treatment is associated with increased risk of complication. Currently, intraoperative observation and imaging findings are used to determine recurrence and success of gross total resection. These methods can be unreliable due to limited operative view, bony and soft tissue involvement, and complex post-operative changes on MRI. Earlier detection of incomplete resection or recurrence will allow for earlier ability to intervene and potentially improve patient outcomes. Circulating-tumor DNA (ctDNA) is cell-free DNA that is released by tumor cells as they undergo cellular turn-over. Monitoring ctDNA has been shown to be more sensitive at predicting residual tumor than imaging in numerous solid malignancies. Furthermore, ctDNA could be detected earlier in peripheral blood as opposed to imaging changes, allowing for earlier intervention. In this review, we intend to give a brief overview of the current state of molecular diagnosis for skull base chordomas. We will then discuss current advances in the utilization of ctDNA for the management of CNS pathologies such as glioblastoma (GBM) and brain metastases. We will also discuss the role ctDNA has in the management of non-CNS pathologies such as osteosarcoma and Ewing sarcoma (EWS). Finally, we will discuss potential implications of ctDNA monitoring for chordoma management.https://www.frontiersin.org/articles/10.3389/fonc.2022.1016385/fullclivusctDNADNAtumorskull basechordoma |
| spellingShingle | Stephen C. Frederico Stephen C. Frederico Corbin Darling Corbin Darling Xiaoran Zhang Sakibul Huq Sameer Agnihotri Paul A. Gardner Carl H. Snyderman Carl H. Snyderman Eric W. Wang Georgios A. Zenonos Circulating tumor DNA – A potential aid in the management of chordomas Frontiers in Oncology clivus ctDNA DNA tumor skull base chordoma |
| title | Circulating tumor DNA – A potential aid in the management of chordomas |
| title_full | Circulating tumor DNA – A potential aid in the management of chordomas |
| title_fullStr | Circulating tumor DNA – A potential aid in the management of chordomas |
| title_full_unstemmed | Circulating tumor DNA – A potential aid in the management of chordomas |
| title_short | Circulating tumor DNA – A potential aid in the management of chordomas |
| title_sort | circulating tumor dna a potential aid in the management of chordomas |
| topic | clivus ctDNA DNA tumor skull base chordoma |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2022.1016385/full |
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