Emma Titmuss. Credit score: American Affiliation for Most cancers Analysis
An ultrasensitive circulating tumor DNA (ctDNA)-based liquid biopsy assay detected indicators of recurrence previous to imaging and offered prognostic worth inside one month after surgical procedure in sufferers with colorectal most cancers (CRC), in line with interim outcomes from the VICTORI research offered on the American Affiliation for Most cancers Analysis (AACR) Annual Assembly 2025, held April 25–30.
Detection of ctDNA after therapy is a robust indicator of recurrence in CRC, but it surely usually goes undetected as a result of traces of ctDNA within the blood may be very low, stated Emma Titmuss, MSc, a bioinformatician at BC Most cancers in Vancouver and the research presenter. If captured early sufficient, blood-based biomarkers might present priceless data that may be integrated into medical decision-making, she defined.
“After surgery, ctDNA-based liquid biopsies may help identify patients who would benefit most from additional treatment,” stated Jonathan Loree, MD, MS, a medical oncologist at BC Most cancers and the senior investigator of the research.
“Alternatively, this may help patients with good prognosis avoid toxicities from unnecessary chemotherapy. By monitoring patients for recurrences, liquid biopsies can continue to support clinical care and allow more patients to undergo second curative intent surgeries to remove early recurrences.”
The VICTORI research goals to establish the optimum timepoint at which detecting ctDNA can predict recurrence following surgical procedure in sufferers with CRC. This interim potential evaluation included 71 sufferers with resectable CRC, 52 with stage 1-3 illness and 19 with stage 4 illness.
The investigators created a personalised, tumor tissue-derived panel of as much as 1,800 somatic variants for every affected person. Liquid biopsies had been taken previous to surgical procedure, each two weeks for eight weeks post-surgery, and each three months for a possible three years, and analyzed with the NeXT Private assay.
All 33 sufferers with treatment-naïve illness larger than stage 1 had detectable ctDNA previous to surgical procedure.
Of 65 sufferers evaluable for medical consequence, 23 skilled medical recurrence, the overwhelming majority (87%) had been ctDNA-positive inside the landmark eight-week post-surgical interval throughout which adjuvant chemotherapy is usually administered.
All sufferers with medical recurrence had been ctDNA-positive earlier than recurrence was detected through reflex imaging, by a median of 198 days earlier, together with difficult-to-detect metastatic websites such because the lung. One affected person had ctDNA recurrence 416 days previous to medical recurrence. Based on Titmuss, ctDNA was detected as little as 2 components per million (ppm). The median ctDNA stage at first detection was 24.4 ppm, and the best was 111,120 ppm. Larger ctDNA ranges at first detection had been linked to shorter occasions to medical relapse.
“The results from our study help to clarify the ideal timepoint for ctDNA testing following a surgical procedure, showing that we can detect residual cancer as early as two weeks following surgery,” stated Titmuss. Nonetheless, with ctDNA assessments this near surgical procedure, there may be the potential for regular cell-free DNA to dilute ctDNA, and 4 weeks seems to be a greater time level clinically to pattern for ctDNA to tell medical decision-making, she added.
The research continues to enroll extra sufferers, which the authors hope will enhance the precision of the outcomes and information future potential research that incorporate ctDNA as a call level for medical administration and care.
One limitation of the research is the dearth of intervention after ctDNA detection as this was an observational research. The authors be aware the necessity for randomized trials to find out the best use of this expertise in medical administration.
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A liquid biopsy-based assay might detect recurrence previous to imaging in sufferers with resectable colorectal most cancers (2025, April 29)
retrieved 30 April 2025
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