Key clinical point: Circulating tumor DNA (ctDNA) has substantiated its role as a strong prognostic biomarker in patients with metastatic colorectal cancer (mCRC). However, uncovering its true clinical value for these patients calls for prospective clinical trials with standardized methodologies.
Major finding: High baseline ctDNA levels were associated with a shorter progression-free survival (PFS; hazard ratio [HR] 2.2; 95% CI 1.8-2.8) and overall survival (OS; HR 2.4; 95% CI 1.9-3.1), with a small or no early decline in ctDNA levels with treatment being associated with a shorter PFS (HR 3.0; 95% CI 2.2-4.2) and OS (HR 2.8; 95% CI 2.1-3.9). Clonal evolution and lead-time results were inconsistent, with most studies having a high bias risk in ≥1 domain.
Study details: Findings are from a meta-analysis of 71 studies that included 6930 patients with mCRC.
Disclosures: The study was supported by the Danish Cancer Society. The authors declared no conflicts of interest.
Source: Callesen LB et al. Circulating tumour DNA and its clinical utility in predicting treatment response or survival in patients with metastatic colorectal cancer: A systematic review and meta-analysis. Br J Cancer. 2022 (Apr 19). Doi: 10.1038/s41416-022-01816-4