ctDNA on liquid biopsy for predicting response and prognosis in locally advanced rectal cancer: A systematic review |
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| Affiliation: | 1. Department of gastroenterology and GI Oncology, Georges-Pompidou European Hospital, AP-HP; Sorbonne Paris cité, Université de Paris, Paris, France;2. Département de chirurgie viscérale oncologique, Gustave Roussy, Villejuif, France;3. Pole biologie, Hospital European George Pompidou, Paris, Île-de-France, France;4. Fédération Francophone de Cancérologie Digestive; EPICAD INSERM LNC-UMR 1231, University of Burgundy and Franche Comté, Dijon, France;5. EA4340, Ambroise Pare Hospital, Beuvry, Hauts-de-France, France;6. Gastroenterology Department and Medical Oncology Department, Poitiers University Hospital, Poitiers, France;7. Department of Gastroenterology, Groupement hospitalier Sud, Hospices civils de Lyon, Pierre Bénite, France;8. Centre de Recherche des Cordeliers, INSERM, CNRS, Sorbonne Université, USPC, Université de Paris, Equipe labellisée Ligue Nationale contre le cancer, Paris, France.;9. Department of digestive oncology University hospital Dijon; University of Burgundy and Franche Comté, Dijon, France;10. Sorbonne Université and Hôpital Saint Antoine, Paris, France;1. Medical Biochemistry Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt;2. Clinical Oncology and Nuclear Medicine Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt;3. Pathology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt;4. Surgery Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt |
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| Abstract: | BackgroundThe management of locally advanced rectal cancer (LARC) requires a multidisciplinary approach, with an increasing interest for non-operative strategies. Liquid biopsy for obtaining circulating tumor DNA (ctDNA) can provide information on neoadjuvant chemoradiotherapy (nCRT) pathological response and cancer-specific prognosis, and therefore might be a promising guide for these treatments.MethodsA systematic review of the studies available in literature has been performed to assess the role of ctDNA as a predictive and prognostic biomarker in LARC patients.ResultsWe retrieved 21 publications, of which 17 full-text articles and 4 abstracts. Results have been labelled into two groups: predictive and prognostic. Data about the usefulness of liquid biopsy in this setting is still inconclusive. However, baseline higher levels of longer fragments of cell-free DNA and integrity index, tumor-specific mutations and certain methylated genes could predict non-responders. Also, undetectable baseline ctDNA and decrease of common rectal cancer mutations throughout treatment (dynamic monitoring) were predictive factors of pathological complete response. The continuous detection of ctDNA in different timepoints of treatment (minimal residual disease) was consistently associated with worse prognosis.ConclusionsctDNA is a promising biomarker that could assist predicting treatment response to nCRT and prognosis in patients with LARC. The ideal methods and timings for the liquid biopsy still have to be defined. |
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| Keywords: | Rectal cancer Chemoradiotherapy Liquid biopsy Circulating-tumor DNA |
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