Clinical Utility of Analyzing Circulating Tumor DNA in Patients with Metastatic Colorectal Cancer

Nakamura, Yoshiaki; Yoshino, Takayuki

doi:10.1634/theoncologist.2017-0621

Cited by 45 publications

(37 citation statements)

References 87 publications

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“…However, molecular testing of the RAS gene is extremely limited because tumor tissue is limited, and biopsies are invasive. More recently, some studies suggested that the consistency of liquid biopsy and tumor-tissue biopsy testing was more than 90% in the detection of the RAS gene (25,26). Liquid biopsy is an important method of monitoring RAS mutation status in mCRC patients.…”

Section: Discussionmentioning

confidence: 99%

A Retrospective Exploration of Targeted Maintenance Therapy in Advanced Colorectal Cancer: Based on the Background of Chinese Patient Assistance Program

Cui

et al. 2020

Front. Oncol.

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Background: Maintenance therapy with bevacizumab (Bev) in patients with colorectal cancer (CRC) provides progression-free survival (PFS) benefits. However, the role of maintenance therapy with an anti-EGFR monoclonal antibody has not been established.Methods: Eligible CRC patients were assigned to maintenance therapy with cetuximab (Cet; Cet group) or Bev (Bev group). PFS, the duration of maintenance therapy, and safety were analyzed. Cox multivariate regression analyses were performed to determine independent prognostic factors.Results: A total of 143 eligible patients were assigned to the Cet (n = 79) or Bev (n = 64) groups. In the Cet group, all patients had KRAS wild-type. The baseline characteristics were well-balanced between the two groups, except for a higher percentage of patients with a left-sided primary tumor in the Cet group than in the Bev group (86.1 vs. 62.5%, P < 0.0001). The median PFS was not significantly different between the Cet group and the Bev group: 5.9 months (95% CI 2.30-9.50) vs. 7.0 months (95% CI 3.69-10.31) (HR 1.17, 95% CI 0.77-1.79, P = 0.45). The median duration of maintenance therapy in the Cet group was shorter than that in the Bev group: 4.0 months (95% CI 1.94-5.99) vs. 4.8 months (95% CI 2.68-6.98) (HR 0.90, 95% CI 0.61-1.33; P = 0.59). The subgroup analyses showed that the median PFS for the first maintenance therapy and the second maintenance therapy were 3.2 months (95% CI 1.69-4.78) and 5.2 months (95% CI 1.58-8.83), respectively (HR 0.89, 95% CI 0.44-1.81; P = 0.75). Conclusions:This study suggests that maintenance therapy with Cet or Bev can be considered an appropriate option following induction chemotherapy for selected patients with advanced CRC. Multiple maintenance therapy seems to confer survival benefits in advanced CRC. Maintenance therapy with Cet after first-line induction chemotherapy seems to be associated with greater survival benefits.

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Section: Discussionmentioning

confidence: 99%

A Retrospective Exploration of Targeted Maintenance Therapy in Advanced Colorectal Cancer: Based on the Background of Chinese Patient Assistance Program

Cui

et al. 2020

Front. Oncol.

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“…However, these biomarkers are concentrated mainly in histochemistry and molecular biology techniques. Their application is limited to a certain extent because of the high price and need for specific experimental equipment [ 3 , 4 ]. Therefore, it continues to be important to find convenient, effective, and inexpensive prognostic markers for patients with GI malignancy.…”

Section: Introductionmentioning

confidence: 99%

Geriatric nutritional risk index as a predictor of complications and long-term outcomes in patients with gastrointestinal malignancy: a systematic review and meta-analysis

et al. 2020

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Background The effect of the geriatric nutritional risk index (GNRI) on the prognosis of patients with gastrointestinal malignancy remains unclear. The aim of our study was to systematically explore the value of the GNRI in evaluating postoperative complications and long-term outcomes in gastrointestinal malignancy. Methods A systematic literature search was conducted using electronic databases to report the impact of the GNRI on postoperative complications and long-term outcomes of patients with gastrointestinal malignancies as of August 2020. The hazard ratio (HR) with a 95% confidence interval (CI) was used to evaluate the impact of the GNRI on long-term outcomes. The risk ratio (RR) with 95% CI was used to assess the impact of the GNRI on postoperative complications. Result A total of nine studies with 2,153 patients were enrolled in our meta-analysis. The results suggested that a low GNRI was correlated with poor overall survival of patients with gastrointestinal malignancy (HR = 1.94, 95% CI 1.65–2.28, p < 0.001). Patients with a low GNRI had a higher risk of complications than patients with a high GNRI (OR = 2.19, 95% CI 1.57–3.05, p < 0.001). In addition, patients with a low GNRI had shorter relapse-free survival (HR = 2.45, 95% CI 1.50–4.00, p < 0.001) and disease-free survival (HR = 1.84, 95% CI 1.23–2.76, p = 0.003) than those with a high GNRI. However, the GNRI was not an independent factor affecting cancer-specific survival (HR = 1.60, 95% CI 0.91–2.82, p = 0.101). Conclusion Based on existing evidence, the GNRI was a valuable predictor of complications and long-term outcomes in patients with gastrointestinal malignancy.

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“…Therefore, in cases with newly developed metastatic liver tumors, US‐guided liver biopsy could be an appropriate approach for tissue‐based clinical sequencing. Liquid biopsy could overcome the limitations of tissue‐based analysis due to intra‐ and intertumor heterogeneity, but will require robust validation . In addition, recent evidence revealed the role of cancer–stroma interactions in the development and progression of cancer .…”

Section: Discussionmentioning

confidence: 99%

Utility of ultrasound‐guided liver tumor biopsy for next‐generation sequencing‐based clinical sequencing

Eso

Kou

Nagai

et al. 2019

Hepatology Research

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Aim Recent advances in next‐generation sequencing (NGS) technologies allow for evaluation of genetic alterations in various cancer‐related genes in daily clinical practice. Archival formalin‐fixed paraffin‐embedded (FFPE) tumor tissue is often used for NGS‐based clinical sequencing assays; however, the success rate of NGS assays using archival FFPE tumor tissue is reported to be lower than that using fresh tumor tissue. We aimed to evaluate the feasibility and safety of ultrasound (US)‐guided liver tumor biopsy for NGS‐based multiplex gene assays. Methods We compared the success rate of NGS assays between archival FFPE tumor tissues and US‐guided liver tumor biopsy tissues, and summarized the treatment progress of the patients. Results Next‐generation sequencing assays using US‐guided liver biopsy samples were successful in all patients (22/22), whereas the success rate with archival FFPE tumor tissue was 84.8% (151/178, P < 0.05). At least one potentially actionable genetic alteration was identified from the US‐guided liver biopsy samples in 20 of 22 patients. Among the 18 patients with actionable genetic alterations targetable with drugs approved by the US Food and Drug Administration, eight initiated mutation‐driven targeted therapies. Of these eight patients, four achieved partial response or stable disease for at least 4 months, and three were not assessable for response due to short exposure. There were no biopsy‐related complications requiring additional treatment. Conclusion Our findings suggest that US‐guided liver tumor biopsy is a useful and safe method for obtaining high‐quality samples for NGS‐based clinical sequencing. In cases with metastatic liver tumors, US‐guided biopsy should be considered to provide accurate and optimal sequencing results for patients.

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Clinical Utility of Analyzing Circulating Tumor DNA in Patients with Metastatic Colorectal Cancer

Cited by 45 publications

References 87 publications

A Retrospective Exploration of Targeted Maintenance Therapy in Advanced Colorectal Cancer: Based on the Background of Chinese Patient Assistance Program

A Retrospective Exploration of Targeted Maintenance Therapy in Advanced Colorectal Cancer: Based on the Background of Chinese Patient Assistance Program

Geriatric nutritional risk index as a predictor of complications and long-term outcomes in patients with gastrointestinal malignancy: a systematic review and meta-analysis

Utility of ultrasound‐guided liver tumor biopsy for next‐generation sequencing‐based clinical sequencing

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