A May paper in PLOS Medicine led by Ludwig Johns Hopkins’ Bert Vogelstein and Yuxuan Wang and Ludwig alumni Jeanne Tie and Peter Gibbs reported that detecting circulating tumor DNA (ctDNA) in patients’ blood after surgery, or following adjuvant chemotherapy, is associated with a very high risk of recurrence and death in patients with resectable colorectal liver metastases (CRLM). An initial study from Bert’s group published in Nature Medicine in 2008 showed that ctDNA detection after surgery or chemotherapy was successful in predicting eventual cancer relapse in 18 patients with colorectal cancer. In the latest study, which recruited 54 patients with CRLM, the researchers found that patients with detectable ctDNA after surgery had an 83% recurrence risk compared to only 31% in those with undetectable ctDNA after surgery. Similarly, ctDNA predicted for recurrence after adjuvant chemotherapy: All 8 patients with detectable postoperative ctDNA who failed to clear their ctDNA following adjuvant chemotherapy experienced recurrence, while 2 of 3 patients whose ctDNA became undetectable after chemotherapy remained disease-free. The authors suggest ctDNA monitoring could be incorporated into routine surveillance to identify patients who are most likely to experience a recurrence after definitive treatment for CRLM. Prospective clinical trials to test this hypothesis are now underway.
This article appeared in the February 2022 issue of Ludwig Link. Click here to download a PDF (1 MB).