Liquid biopsy for rectal cancer: A systematic review

Abstract

Background: The management of locally advanced rectal cancer (RC) is an evolving clinical field where the multidisciplinary approach can reach its best and liquid biopsy for obtaining tumor-derived component such as circulating tumor DNA (ctDNA) might provide complementary informations. Methods: A systematic review of studies available in literature of liquid biopsy in non-metastatic RC has been performed according to PRISMA criteria to assess the role of ctDNA as a diagnostic, predictive and prognostic biomarker in this setting. Results: Twenty-five publications have been retrieved, of which 8 fulltext articles, 7 abstracts and 10 clinical trials. Results have been categorized into three groups: diagnostic, predictive and prognostic. Few but promising data are available about the use of liquid biopsy for early diagnosis of RC, with the main limitation of sensitivity due to low concentrations of ctDNA in this setting. In terms of prediction of response to chemoradiation, still inconclusive data are available about the utility of a pre-treatment liquid biopsy, whereas some studies report a positive correlation with a dynamic (pre/post-treatment) monitoring. The presence of minimal residual disease by ctDNA was consistently associated with worse prognosis across studies. Conclusions: The use of liquid biopsy for monitoring response to chemoradiation and assess the risk of disease recurrence are the most advanced potential applications for liquid biopsy in RC, with implications also in the context of non-operative management strategies.

The Clinical Value of the Combined Detection of Enhanced CT, MRI, CEA, and CA199 in the Diagnosis of Rectal Cancer

“…However, as the infiltration of RC in the early intestinal wall is not significant, and enhanced CT is difficult to stratify the patient's intestinal wall, preoperative staging diagnosis often lacks good accuracy, especially for the detection of early RC [24]. MRI can distinguish the three-layer structure of intestinal wall and the adjacent fat background rectal fascia, which is suitable for the benign and malignant differentiation and accurate staging of tumors [25,26]. MRI can conduct comprehensive detection of tumor properties, layers of structure, lymph node metastasis, and organ infiltration in the patient's body and directly obtain comprehensive image information by skipping image and information reconstruction [27,28].…”

The notch target gene HEYL modulates metastasis forming capacity of colorectal cancer patient-derived spheroid cells in vivo

“…In different human cancers, the numbers of detectable circulating tumor cells (CTCs) are associated with a worse outcome [52–54]. Interestingly, recent evidence indicates that distinct Notch pathway members are expressed in CTCs and may positively influence their metastatic potential [55–57].…”

Germline and Somatic Pharmacogenomics to Refine Rectal Cancer Patients Selection for Neo-Adjuvant Chemoradiotherapy

“…A number of researchers investigated the role of ctDNA as a biomarker of the therapeutic outcome in LARC and the results were recently reviewed by Massinhia and colleagues (Massihnia et al, 2019). Particularly a study by Tie et al (2019) analyzed in a large group of 159 patients with LARC by sequencing cell free DNA in serial plasma samples at the time of diagnosis, after nCRT and after surgery demonstrating that the tumor DNA fraction level in plasma was significantly related to the risk of treatment failure.…”