The Current Role of Circulating Tumor DNA in the Management of Pancreatic Cancer.

IF 1.6 Q4 ONCOLOGY Journal of Gastrointestinal Cancer Pub Date : 2025-01-14 DOI:10.1007/s12029-024-01129-0
Madison Cox, Dominic J Vitello, Akhil Chawla
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Abstract

Pancreatic ductal adenocarcinoma (PDAC) is projected to be the second leading cause of cancer-related death by 2030. Early identification is rare, with a 5-year overall survival (OS) of less than 10%. Advances in the understanding of PDAC tumor biology are needed to improve these outcomes. Circulating tumor DNA (ctDNA) represents a promising novel biomarker in the identification and management of PDAC. Drawn from peripheral blood and analyzed using a variety of techniques, the detection of ctDNA in PDAC has been associated with shorter OS, minimal residual disease presence, and shorter recurrence-free survival. The use of ctDNA has also been examined as an indicator of therapeutic resistance, susceptibility to targeted therapy, and therapeutic response. While promising, ctDNA analysis is limited by its low rates of detection in some settings and lack of predictive ability in others. Many studies examining the utility of ctDNA for the management of PDAC have been relatively small retrospective cohort studies. The current findings will need to be validated by incorporation of ctDNA analysis into cancer registries and larger prospective studies. Given the current, rapid evolution in the field, it is possible that with time, ctDNA will be more routinely incorporated into the clinical management of PDAC.

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循环肿瘤DNA在胰腺癌治疗中的作用。
预计到2030年,胰腺导管腺癌(PDAC)将成为癌症相关死亡的第二大原因。早期发现是罕见的,5年总生存率(OS)小于10%。我们需要进一步了解PDAC肿瘤生物学来改善这些结果。循环肿瘤DNA (ctDNA)是一种很有前途的新型生物标志物,可用于PDAC的鉴定和治疗。从外周血中提取并使用多种技术进行分析,发现在PDAC中检测ctDNA与更短的OS、最小的残留疾病存在和更短的无复发生存期相关。ctDNA的使用也被检测为治疗耐药性、靶向治疗易感性和治疗反应的指标。虽然ctDNA分析很有前景,但它在某些情况下的检出率很低,在其他情况下缺乏预测能力,因此受到限制。许多关于ctDNA在PDAC治疗中的应用的研究都是相对较小的回顾性队列研究。目前的发现需要通过将ctDNA分析纳入癌症登记处和更大规模的前瞻性研究来验证。鉴于目前该领域的快速发展,随着时间的推移,ctDNA可能会更常规地纳入PDAC的临床管理。
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来源期刊
CiteScore
3.80
自引率
0.00%
发文量
121
期刊介绍: The Journal of Gastrointestinal Cancer is a multidisciplinary medium for the publication of novel research pertaining to cancers arising from the gastrointestinal tract.The journal is dedicated to the most rapid publication possible.The journal publishes papers in all relevant fields, emphasizing those studies that are helpful in understanding and treating cancers affecting the esophagus, stomach, liver, gallbladder and biliary tree, pancreas, small bowel, large bowel, rectum, and anus. In addition, the Journal of Gastrointestinal Cancer publishes basic and translational scientific information from studies providing insight into the etiology and progression of cancers affecting these organs. New insights are provided from diverse areas of research such as studies exploring pre-neoplastic states, risk factors, epidemiology, genetics, preclinical therapeutics, surgery, radiation therapy, novel medical therapeutics, clinical trials, and outcome studies.In addition to reports of original clinical and experimental studies, the journal also publishes: case reports, state-of-the-art reviews on topics of immediate interest or importance; invited articles analyzing particular areas of pancreatic research and knowledge; perspectives in which critical evaluation and conflicting opinions about current topics may be expressed; meeting highlights that summarize important points presented at recent meetings; abstracts of symposia and conferences; book reviews; hypotheses; Letters to the Editors; and other items of special interest, including:Complex Cases in GI Oncology:  This is a new initiative to provide a forum to review and discuss the history and management of complex and involved gastrointestinal oncology cases. The format will be similar to a teaching case conference where a case vignette is presented and is followed by a series of questions and discussion points. A brief reference list supporting the points made in discussion would be expected.
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