Liquid biopsy for monitoring minimal residual disease in colorectal cancer: A promising approach with clinical implications

Zhexue Wang , Junge Bai , Dedi Jiang , Yuegang Li , Xiyue Hu , Sergey Efetov , Yu Cao , Cuneyt Kayaalp , Audrius Dulskas , Darcy Shaw , Ming Yang , Zheng Liu , Xishan Wang
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Abstract

Colorectal cancer (CRC) is a global health concern, ranking among the leading causes of cancer-related mortality. This review critically evaluates the role of liquid biopsy in detecting minimal residual disease (MRD) in CRC. The increasing incidence, particularly in China, highlights the urgency of innovative approaches for early prediction of recurrence and metastasis. The importance of MRD should be underscored as residual tumor cells post-treatment significantly impact patient prognosis. Liquid biopsy methods, including circulating tumor DNA (ctDNA), circulating tumor cells (CTCs), exosomes, and circulating tumor RNA, are dissected for their potential in identifying molecular markers associated with CRC. The focus on ctDNA highlights its non-invasive nature, real-time monitoring capabilities, and superiority over traditional detection methods in terms of sensitivity and timeliness. The review also delves into the limitations, such as clonal hematopoiesis and the critical consideration of optimal timing for postoperative ctDNA detection. In conclusion, the review highlights the significant potential of liquid biopsy, particularly ctDNA, as a dynamic and non-invasive tool for MRD detection in CRC. By complementing traditional methods, liquid biopsy contributes to precision in tumor research and personalized treatment. These advancements offer promising avenues for improving CRC patient prognosis and tailoring individualized treatment strategies.

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用于监测结直肠癌最小残留病灶的液体活检:具有临床意义的可行方法
结直肠癌(CRC)是全球关注的健康问题,是癌症相关死亡的主要原因之一。本综述批判性地评估了液体活检在检测结直肠癌最小残留病(MRD)中的作用。发病率的不断上升,尤其是在中国,凸显了早期预测复发和转移的创新方法的紧迫性。应该强调 MRD 的重要性,因为治疗后残留的肿瘤细胞会对患者的预后产生重大影响。液体活检方法包括循环肿瘤 DNA (ctDNA)、循环肿瘤细胞 (CTC)、外泌体和循环肿瘤 RNA,它们在确定与 CRC 相关的分子标记物方面的潜力得到了剖析。ctDNA的重点在于其非侵入性、实时监测能力以及在灵敏度和及时性方面优于传统检测方法。综述还深入探讨了其局限性,如克隆造血和术后 ctDNA 检测最佳时机的关键考虑因素。总之,综述强调了液体活检(尤其是ctDNA)作为一种动态、无创的工具在检测 CRC MRD 方面的巨大潜力。通过对传统方法的补充,液体活检有助于肿瘤研究的精确性和个性化治疗。这些进展为改善 CRC 患者预后和定制个体化治疗策略提供了前景广阔的途径。
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