Waiting for the “liquid revolution” in the adjuvant treatment of colon cancer patients: a review of ongoing trials

IF 9.6 1区 医学 Q1 ONCOLOGY Cancer treatment reviews Pub Date : 2024-04-04 DOI:10.1016/j.ctrv.2024.102735
V. Conca , P. Ciracì , C. Boccaccio , A. Minelli , C. Antoniotti , C. Cremolini
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Abstract

Since colon cancer has a high rate of shedding of tumour fragments into the blood, several research efforts are now focused on the investigation of the minimal residual disease through the detection of ctDNA to tailor the adjuvant therapy of colon cancer patients and optimize its cost/effectiveness balance. The negative prognostic impact of detectable ctDNA in patients’ blood after radical surgery for colon cancer is well established. Several clinical trials adopting heterogeneous designs and techniques are now ongoing to translate promises into daily practice by answering five general questions: i) is a ctDNA-guided decision making efficacious in the post-operative management of colon cancer patients? ii) are de-escalation strategies possible in ctDNA-negative cases? iii) are escalation strategies useful to improve the prognosis of ctDNA-positive patients? iv) when MRD is identified at the end of the adjuvant chemotherapy, is another post-adjuvant systemic therapy efficacious? v) can we exploit ctDNA technologies in the follow up of colon cancer patients? This review focuses on currently ongoing trials and how their results may affect the ctDNA “liquid revolution” of early colon cancer.

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等待结肠癌患者辅助治疗的 "液体革命":正在进行的试验回顾
由于结肠癌的血液中肿瘤碎片脱落率很高,目前一些研究工作侧重于通过检测ctDNA来调查微小残留病灶,从而为结肠癌患者量身定制辅助治疗方案,并优化其成本/疗效平衡。结肠癌根治术后患者血液中可检测到的ctDNA对预后的负面影响已得到证实。目前正在进行的几项临床试验采用了不同的设计和技术,旨在通过回答以下五个一般性问题将承诺转化为日常实践:i) ctDNA 指导下的决策对结肠癌患者的术后管理是否有效?iv) 当辅助化疗结束时发现 MRD,再次辅助化疗后系统治疗是否有效?本综述将重点关注目前正在进行的试验,以及这些试验的结果会如何影响早期结肠癌的ctDNA "液体革命"。
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来源期刊
Cancer treatment reviews
Cancer treatment reviews 医学-肿瘤学
CiteScore
21.40
自引率
0.80%
发文量
109
审稿时长
13 days
期刊介绍: Cancer Treatment Reviews Journal Overview: International journal focused on developments in cancer treatment research Publishes state-of-the-art, authoritative reviews to keep clinicians and researchers informed Regular Sections in Each Issue: Comments on Controversy Tumor Reviews Anti-tumor Treatments New Drugs Complications of Treatment General and Supportive Care Laboratory/Clinic Interface Submission and Editorial System: Online submission and editorial system for Cancer Treatment Reviews
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