Liquid Biopsies in Colorectal Liver Metastases: Towards the Era of Precision Oncologic Surgery

Tsilimigras, Diamantis I.; Ntanasis‐Stathopoulos, Ioannis; Pawlik, Timothy M.

doi:10.3390/cancers14174237

Cited by 4 publications

(3 citation statements)

References 71 publications

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“…Therefore, it could be a feasible option for them to be actively surveilled instead of receiving adjuvant chemotherapy, thus sparing this population from the toxic effects of chemotherapy and the risk of the ATRESS phenomenon. The longitudinal ctDNA before, during and after adjuvant chemotherapy could also provide a patient-level measurement of its effectiveness [ 74 ]. Finally, the impact of various predictive biomarkers on already existing or new regimens should be further investigated either in parallel or genotype-driven (umbrella/basket trials) clinical trials.…”

Section: Discussionmentioning

confidence: 99%

Optimizing Adjuvant Therapy after Surgery for Colorectal Cancer Liver Metastases: A Systematic Review

Georgilis

Gavriatopoulou

Tsilimigras

et al. 2023

JCM

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The liver is the most common site of colorectal cancer metastatic spread. Although metastasectomy is the gold standard for fit patients with resectable colorectal cancer liver metastases (CRLMs), their management after surgical treatment remains controversial. The objective of this systematic review was to collate the currently available data of the agents used in the adjuvant setting in order to define the most optimal therapeutic strategy. A systematic review of the literature was conducted by searching PubMed/Medline and Cochrane library databases. We included studies that evaluated the efficacy, the tolerability and the safety profile of various chemotherapeutic agents that are used as adjuvant treatment after surgical resection of CRLMs. The outcomes of interest were regression-free survival (RFS), disease-free survival (DFS), overall survival (OS) and severe toxicities. From 543 initial articles, 29 publications with 7028 patients were finally included. In general, the results of the eligible studies indicated that adjuvant therapy after resection of CRLMs led to improved RFS/DFS rates, but this benefit did not contribute to a statistically significant prolongation of OS. Moreover, the choice of the therapeutic strategy, namely systematic or regional chemotherapy or the combination of both, did not seem to have a differential impact on patient outcomes. However, these results should be interpreted with caution since the majority of the chosen studies are of low or moderate quality. In this context, further high-quality clinical trials conducted on patient sub-populations with modern therapies are required in order to reduce in-study and between-study heterogeneity and determine which patients are expected to derive the maximum benefit from adjuvant therapy after surgery for CRLMs.

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Section: Discussionmentioning

confidence: 99%

Optimizing Adjuvant Therapy after Surgery for Colorectal Cancer Liver Metastases: A Systematic Review

Georgilis

Gavriatopoulou

Tsilimigras

et al. 2023

JCM

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“…Exosomes can promote tumor growth and metastasis by modulating the microenvironment and promoting angiogenesis, invasion, and immune evasion. 45 Exosomes secreted by cancer cells can also transfer oncogenic factors, such as miRNAs and proteins, to adjacent or distant cells, thereby promoting or inhibiting cancer development and resistance to therapy 46 In the early stages of cancer, cancer cell-derived exosomes can induce apoptosis of neighboring cells, thereby promoting tumor development. However, in the later stages of cancer, cancer cell-derived exosomes can inhibit the apoptosis of cancer cells, thereby promoting tumor survival and resistance to therapy.…”

Section: Apoptosismentioning

confidence: 99%

The role of exosomes in cancer‐related programmed cell death

Li,

Jing,

et al. 2023

Immunological Reviews

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SummaryCancer arises from the growth and division of uncontrolled erroneous cells. Programmed cell death (PCD), or regulated cell death (RCD), includes natural processes that eliminate damaged or abnormal cells. Dysregulation of PCD is a hallmark of cancer, as cancer cells often evade cell death and continue to proliferate. Exosomes nanoscale extracellular vesicles secreted by different types of cells carrying a variety of molecules, including nucleic acids, proteins, and lipids, to have indispensable role in the communication between cells, and can influence various cellular processes, including PCD. Exosomes have been shown to modulate PCD in cancer cells by transferring pro‐ or antideath molecules to neighboring cells. Additionally, exosomes can facilitate the spread of PCD to surrounding cancer cells, making them promising in the treatment of various cancers. The exosomes' diagnostic potential in cancer is also an active area of research. Exosomes can be isolated from a wide range of bodily fluids and tissues, such as blood and urine, and can provide a noninvasive way to monitor cancer progression and treatment response. Furthermore, exosomes have also been employed as a delivery system for therapeutic agents. By engineering exosomes to carry drugs or other therapeutic molecules, they can be targeted specifically to cancer cells, reducing toxicity to healthy tissues. Here, we discussed exosomes in the diagnosis and prevention of cancers, tumor immunotherapy, and drug delivery, as well as in different types of PCD.

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“…83 An increasing number of studies suggest that ctDNA could predict outcomes in patients with CRLM undergoing metastasectomy. 84,85 In a recent prospective study from MD Anderson Cancer Center, perioperative ctDNA analyses of blood samples were conducted in 48 patients with CRLM undergoing hepatectomy. 86 Patients with positive ctDNA before and after surgery (ctDNA+/+ ) just had of 6.0 months, significantly lower than the 33.0 months of patients with negative ctDNA before and after surgery (ctDNA À/À ).…”

Section: Microsatellite Instability and Deficient Deoxyribonucleic Ac...mentioning

confidence: 99%

Impact of Molecular Status on Metastasectomy of Colorectal Cancer Liver Metastases

Wang

Xin

Wang

2023

Clin Colon Rectal Surg

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Although surgical resection could provide better survival for patients with colorectal cancer liver metastases (CRLM), the recurrence rate after resection of CRLM remains high. The progress of genome sequencing technologies has greatly improved the molecular understanding of colorectal cancer. In the era of genomics and targeted therapy, genetic mutation analysis is of great significance to guide systemic treatment and identify patients who can benefit from resection of CRLM. RAS and BRAF mutations and microsatellite instability/deficient deoxyribonucleic acid (DNA) mismatch repair status have been incorporated into current clinical practice. Other promising molecular biomarkers such as coexisting gene mutations and circulating tumor DNA are under active investigation. This study aimed to review the prognostic significance of molecular biomarkers in patients with CRLM undergoing metastasectomy based on the current evidence.

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Liquid Biopsies in Colorectal Liver Metastases: Towards the Era of Precision Oncologic Surgery

Cited by 4 publications

References 71 publications

Optimizing Adjuvant Therapy after Surgery for Colorectal Cancer Liver Metastases: A Systematic Review

Optimizing Adjuvant Therapy after Surgery for Colorectal Cancer Liver Metastases: A Systematic Review

The role of exosomes in cancer‐related programmed cell death

Impact of Molecular Status on Metastasectomy of Colorectal Cancer Liver Metastases

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