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Circulating tumor DNA in advanced solid tumors: Clinical relevance and future directions.
Literature Information
| DOI | 10.3322/caac.21650 |
|---|---|
| PMID | 33165928 |
| Journal | CA: a cancer journal for clinicians |
| Impact Factor | 232.4 |
| JCR Quartile | Q1 |
| Publication Year | 2021 |
| Times Cited | 91 |
| Keywords | circulating tumor DNA, genomic profiling, liquid biopsy, plasma cell-free DNA, precision oncology |
| Literature Type | Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Review |
| ISSN | 0007-9235 |
| Pages | 176-190 |
| Issue | 71(2) |
| Authors | Michael L Cheng, Eirini Pectasides, Glenn J Hanna, Heather A Parsons, Atish D Choudhury, Geoffrey R Oxnard |
TL;DR
This review highlights the growing use of plasma circulating tumor DNA (ctDNA) genomic profiling assays in managing advanced solid tumors, emphasizing their potential to enhance treatment decision-making despite the associated complexities. The authors discuss the current applications and ongoing research related to ctDNA assays, indicating their significance in improving patient outcomes in oncology care.
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circulating tumor DNA · genomic profiling · liquid biopsy · plasma cell-free DNA · precision oncology
Abstract
The application of genomic profiling assays using plasma circulating tumor DNA (ctDNA) is rapidly evolving in the management of patients with advanced solid tumors. Diverse plasma ctDNA technologies in both commercial and academic laboratories are in routine or emerging use. The increasing integration of such testing to inform treatment decision making by oncology clinicians has complexities and challenges but holds significant potential to substantially improve patient outcomes. In this review, the authors discuss the current role of plasma ctDNA assays in oncology care and provide an overview of ongoing research that may inform real-world clinical applications in the near future.
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Primary Questions Addressed
- What are the specific challenges faced by clinicians when integrating ctDNA testing into treatment decision-making for advanced solid tumors?
- How do different plasma ctDNA technologies compare in terms of sensitivity and specificity for detecting mutations in advanced solid tumors?
- What ongoing research is currently being conducted to enhance the clinical applications of ctDNA assays in oncology?
- In what ways could the use of ctDNA profiling change the landscape of personalized medicine for patients with advanced solid tumors?
- How does the timing of ctDNA testing impact the management and prognosis of patients undergoing treatment for advanced solid tumors?
Key Findings
1. Research Background and Purpose: The landscape of oncology is increasingly being transformed by advancements in genomic profiling, particularly through the utilization of circulating tumor DNA (ctDNA). This study focuses on the clinical relevance of ctDNA in the management of patients with advanced solid tumors. The primary objective is to evaluate the current applications of plasma ctDNA technologies in clinical practice, understand their complexities, and explore future directions that might enhance treatment outcomes for cancer patients.
2. Main Methods and Findings: The review discusses a variety of ctDNA technologies employed in both commercial and academic settings. These methods facilitate the detection of genetic mutations and alterations in tumor DNA circulating in the plasma, offering insights into tumor behavior and treatment responses. The authors highlight that while these assays are becoming more routine, there remain significant challenges in their integration into clinical decision-making processes. Key findings indicate that plasma ctDNA testing can provide critical information for personalized therapy, monitoring treatment efficacy, and detecting minimal residual disease, thereby supporting informed clinical decisions. Moreover, ongoing research is being outlined, which aims to further validate these technologies and their clinical applications.
3. Core Conclusions: The review concludes that plasma ctDNA assays represent a promising avenue for improving the management of advanced solid tumors. Despite the complexities involved in their implementation, the potential benefits in personalizing treatment and enhancing patient outcomes are substantial. The integration of ctDNA testing into routine clinical practice is likely to evolve, driven by ongoing research and technological advancements that aim to address current limitations.
4. Research Significance and Impact: This research is significant as it underscores the transformative potential of ctDNA in oncology, particularly for advanced solid tumors. By facilitating a more personalized approach to cancer treatment, ctDNA testing can lead to better patient stratification, optimize therapeutic interventions, and ultimately improve survival rates. The findings also highlight an urgent need for further studies to refine these assays and establish standardized protocols, ensuring their effective application in real-world settings. As the field continues to evolve, the integration of ctDNA into clinical practice could revolutionize oncological care, making it more responsive to the individual needs of patients.
Literatures Citing This Work
- Circulating Methylated DNA to Monitor the Dynamics of RAS Mutation Clearance in Plasma from Metastatic Colorectal Cancer Patients. - Chiara Nicolazzo;Ludovic Barault;Salvatore Caponnetto;Marco Macagno;Gianluigi De Renzi;Angela Gradilone;Francesca Belardinilli;Enrico Cortesi;Federica Di Nicolantonio;Paola Gazzaniga - Cancers (2020)
- Usefulness of Circulating Tumor DNA in Identifying Somatic Mutations and Tracking Tumor Evolution in Patients With Non-small Cell Lung Cancer. - Moom R Roosan;Isa Mambetsariev;Rebecca Pharaon;Jeremy Fricke;Hatim Husain;Karen L Reckamp;Marianna Koczywas;Erminia Massarelli;Andrea H Bild;Ravi Salgia - Chest (2021)
- Next-Generation Sequencing with Liquid Biopsies from Treatment-Naïve Non-Small Cell Lung Carcinoma Patients. - Paul Hofman - Cancers (2021)
- The Detection of Cancer Epigenetic Traces in Cell-Free DNA. - Anastasia P Koval;Konstantin A Blagodatskikh;Nikolay E Kushlinskii;Dmitry S Shcherbo - Frontiers in oncology (2021)
- Postoperative circulating tumor DNA as markers of recurrence risk in stages II to III colorectal cancer. - Gong Chen;Junjie Peng;Qian Xiao;Hao-Xiang Wu;Xiaojun Wu;Fulong Wang;Liren Li;Peirong Ding;Qi Zhao;Yaqi Li;Da Wang;Yang Shao;Hua Bao;Zhizhong Pan;Ke-Feng Ding;Sanjun Cai;Feng Wang;Rui-Hua Xu - Journal of hematology & oncology (2021)
- Liquid biopsy for therapy monitoring in early-stage non-small cell lung cancer. - Misako Nagasaka;Mohammed Hafiz Uddin;Mohammed Najeeb Al-Hallak;Sarah Rahman;Suresh Balasubramanian;Ammar Sukari;Asfar S Azmi - Molecular cancer (2021)
- The Role of Circulating Tumor DNA in Advanced Non-Small Cell Lung Cancer Patients Treated With Immune Checkpoint Inhibitors: A Systematic Review and Meta-Analysis. - Haowei Wang;Fei Zhou;Meng Qiao;Xuefei Li;Chao Zhao;Lei Cheng;Xiaoxia Chen;Caicun Zhou - Frontiers in oncology (2021)
- Clinical Outcomes in Non-Small-Cell Lung Cancer Patients Treated With EGFR-Tyrosine Kinase Inhibitors and Other Targeted Therapies Based on Tumor Versus Plasma Genomic Profiling. - Hai T Tran;Vincent K Lam;Yasir Y Elamin;Lingzhi Hong;Rivka Colen;Nabil A Elshafeey;Islam S A Hassan;Mehmet Altan;George R Blumenschein;Waree Rinsurongkawong;Melvin J Rivera;Mayra E Vasquez;Brett W Carter;Lauren E Byers;Anne S Tsao;Don L Gibbons;Frank Fossella;Bonnie S Glisson;Jianjun Zhang;John V Heymach - JCO precision oncology (2021)
- Efficacy of Osimertinib in NSCLC Harboring Uncommon EGFR L861Q and Concurrent Mutations: Case Report and Literature Review. - Ruiting Lin;Ruilian Chen;Zhiqiang Chen;Leihao Hu;Wei Guo;Zexin Zhang;Lizhu Lin;Hanrui Chen - Frontiers in oncology (2021)
- Circulating tumor cells in colorectal cancer in the era of precision medicine. - Mingchao Hu;Zhili Wang;Zeen Wu;Pi Ding;Renjun Pei;Qiang Wang;Chungen Xing - Journal of molecular medicine (Berlin, Germany) (2022)
... (81 more literatures)
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