Treatment stratification and prognosis assessment using circulating tumor DNA in locally advanced rectal cancer: A systematic review and meta‐analysis

Mi, Junjie; Wang, Rong; Han, Xiaofang; Ma, Rujian; Zhao, Danyu

doi:10.1002/cam4.6434

Cited by 2 publications

(2 citation statements)

References 65 publications

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“…[33] evaluated the role of ctDNA in predicting treatment response and prognosis, and reported similar findings [32,33]. However, the largest number of primary studies were incorporated in this review.…”

Section: Discussionmentioning

confidence: 78%

“…The strength of this study is that it is the largest systematic review and meta-analysis in the literature to assess the role of ctDNA in the management of LARC. It included a number of good quality cohort studies with consistent results regarding role of pre-and postoperative ctDNA when compared to other published reviews on this topic [31][32][33].…”

Section: Discussionmentioning

confidence: 99%

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ctDNA as a predictor of outcome after curative resection for locally advanced rectal cancer: systematic review and meta‐analysis

Nassar,

Aly,

Jin

et al. 2024

Colorectal Disease

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AimTo assess the efficacy of ctDNA measurement at different time intervals in predicting response and prognosis in patients diagnosed with locally advanced rectal cancer (LARC) who underwent neoadjuvant treatment prior to curative resection.MethodEnglish language randomized controlled trials and observational studies, published from 1946 to January 2024, comparing outcomes between ctDNA‐positive and ctDNA‐negative patients with LARC undergoing neoadjuvant treatment prior to curative surgical resection were included in the search. The search included Ovid MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and the Cochrane Database of Systematic Reviews (CDSR).ResultsData for 1022 patients were analysed. Patients with positive ctDNA in the preoperative period had more than five times the risk of developing distant metastasis (RR [95% CI] 5.03 [3.31–7.65], p < 0.001), while those with positive ctDNA in the postoperative period had more than six times the risk (RR [95% CI] 6.17 [2.38–15.95], p < 0.001). There was no significant relationship between ctDNA status at baseline, pre‐, or postoperative periods and achievement of pCR (RR [95% CI] 1.21 [0.86–1.7], 1.82 [0.94–3.55], 1.48 [0.78–2.82], p = 0.27, 0.08, and 0.23, respectively). However, patients with positive ctDNA in the pre‐ and postoperative periods had more than 13 and 12 times the risk of overall disease relapse after curative‐intent treatment (RR [95% CI] 13.55 [7.12–25.81], 12.14 [3.19–46.14], p < 0.001), respectively.ConclusionctDNA could potentially guide treatment and follow‐up in LARC, predicting high‐risk patients for disease relapse, allowing individualized surveillance and treatment strategies. Prospective studies are needed for standardization.

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Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 99%

ctDNA as a predictor of outcome after curative resection for locally advanced rectal cancer: systematic review and meta‐analysis

Nassar,

Aly,

Jin

et al. 2024

Colorectal Disease

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Circulating DNA in Rectal Cancer to Unravel the Prognostic Potential for Radiation Oncologist

Fiorica,

Mandarà,

Giuliani

et al. 2024

American Journal of Clinical Oncology

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Objectives: Liquid biopsy, with its noninvasive nature and ability to detect tumor-specific genetic alterations, emerges as an ideal biomarker for monitoring recurrences for locally advanced rectal cancer (LARC). Completed studies have small sample sizes and different experimental methods. To consolidate and assess the collective evidence regarding the prognostic role of circulating DNA (ctDNA) detection in LARC patients undergoing neoadjuvant chemoradiotherapy (nCRT). Methods: Computerized bibliographic searches of MEDLINE and CANCERLIT (2000 to 2023) were supplemented with hand searches of reference lists. Study selection: studies evaluating oncological outcomes of patients with LARC treated with a nCRT comparing patients with positive and negative liquid biopsy at baseline and after nCRT. Data extraction: data on population, intervention, and outcomes were extracted from each study, in accordance with the intention to treat method, by 2 independent observers, and combined using the DerSimonian method and Laird method. Results: Nine studies follow inclusion criteria including 678 patients treated with nCRT. The pooled RD rate of ctDNA negative between measure at baseline and after nCRT is statistically significant 61% (95% CI: 53-70, P=0.0002). The hazard ratio (HR) of progression-free survival between ct-DNA negative and positive is significant 7.41 (95% CI: 4.87-11.289, P<0.00001). Conclusions: ctDNA can identify patients with different recurrence risks following nCRT and assess prognosis in patients with LARC. Further prospective study is necessary to determine the utility of ctDNA in personalised therapy for patients with LARC.

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Treatment stratification and prognosis assessment using circulating tumor DNA in locally advanced rectal cancer: A systematic review and meta‐analysis

Cited by 2 publications

References 65 publications

ctDNA as a predictor of outcome after curative resection for locally advanced rectal cancer: systematic review and meta‐analysis

ctDNA as a predictor of outcome after curative resection for locally advanced rectal cancer: systematic review and meta‐analysis

Circulating DNA in Rectal Cancer to Unravel the Prognostic Potential for Radiation Oncologist

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