Circulating tumor DNA predicts recurrence in patients receiving adjuvant hepatic artery infusion chemotherapy for resected colorectal liver metastases

Abstract

Objective

The role of circulating tumor DNA (ctDNA) in management of patients with colorectal cancer is evolving, however, there are no data on ctDNA monitoring in patients with resected colorectal liver metastases (CRLM) who receive adjuvant hepatic artery (HAI) chemotherapy. We report our center’s initial experience with postoperative ctDNA monitoring in patients receiving adjuvant HAI chemotherapy.

Summary background

Adjuvant HAI chemotherapy improves survival after CRLM resection. ctDNA has been shown to predict recurrence in patients with resected CRLM, however no ctDNA data are available in patients who receive adjuvant HAI chemotherapy.

Methods

All patients with CRLM who underwent surgical resection and HAI pump placement at our center were included in this study. Demographic, clinicopathologic, radiographic, and ctDNA data are reported.

Results

From 2019–2024, 13 patients with CRLM underwent surgical resection and HAI pump placement and had ctDNA testing. With median follow-up of 2.6 years (1.14–4.15), 11 (85 %) patients experienced recurrence at a median of 7.9 months (2.3–22.5). In total, 10 (77 %) patients were ctDNA-positive all of whom had radiographic evidence of recurrence. Three patients have died at the time of last follow-up.

Conclusions

After surgical resection and HAI chemotherapy, ctDNA was detectable in most patients, and was associated with radiographic recurrence in all ctDNA-positive patients. We report a high recurrence rate in this series of heavily-pretreated patients with known risk factors for recurrence.