Circulating Tumor DNA as a Marker of Recurrence Risk in Stage III Colorectal Cancer: The α-CORRECT Study.

IF 2 3区医学 Q3 ONCOLOGY

Journal of Surgical Oncology Pub Date : 2025-01-25 DOI:10.1002/jso.27989

Brenda Diergaarde, Greg Young, David W Hall, Amin Mazloom, Gina L Costa, Soma Subramaniam, Melanie R Palomares, Jorge Garces, Frederick L Baehner, Robert E Schoen

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引用次数: 0

Abstract

Background and objectives: Identification of colorectal cancer (CRC) patients at high risk of recurrence could be of substantial clinical use. We evaluated the association of ctDNA status, using a tumor-informed assay, with recurrence-free survival (RFS).

Methods: Stage III CRC patients were enrolled between 2016 and 2020. Tumor tissue and serial (every 3 months for years 1-3, biannually for years 4-5) blood samples were collected. Utilizing whole-exome sequencing and selection of 50-200 variants for tumor informed assays, ctDNA status was determined using plasma cell-free DNA.

Results: Of 137 patients enrolled, 124 with 1029 ctDNA results were included in the analyses. Median follow-up was 4.8 years. Plasma ctDNA status was strongly associated with risk of recurrence during the surveillance period (hazard ratio (HR) 49.6, 95% CI: 16.6-148.3; p < 0.0001), and at the postsurgical (HR 9.6, 95% CI: 3.2-29.5) and postdefinitive therapy timepoints (HR: 16.7, 95% CI: 6.9-40.3). The estimated 3-year RFS for ctDNA positive and ctDNA negative patients were, respectively, 54.5% and 96.1% after surgery, and 18.2% and 90.0% after definitive therapy. Multivariable analysis indicated ctDNA but not CEA was strongly prognostic for recurrence.

Conclusions: Our tumor-informed ctDNA assay was strongly prognostic for recurrence in patients with stage III colorectal cancer at all timepoints.

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循环肿瘤DNA作为III期结直肠癌复发风险的标志物：α-CORRECT研究

背景与目的：鉴别结直肠癌（CRC）复发高危患者具有重要的临床意义。我们评估了ctDNA状态与无复发生存（RFS）的关系，使用肿瘤信息分析。方法：纳入2016年至2020年期间的III期CRC患者。采集肿瘤组织和连续（1-3年每3个月，4-5年每半年）血液样本。利用全外显子组测序和选择50-200个变体进行肿瘤检测，利用无浆细胞DNA确定ctDNA状态。结果：在纳入的137例患者中，124例的1029 ctDNA结果被纳入分析。中位随访时间为4.8年。在监测期间，血浆ctDNA状态与复发风险密切相关(危险比（HR） 49.6, 95% CI: 16.6-148.3；结论：我们的肿瘤信息ctDNA检测在所有时间点对III期结直肠癌患者的复发都有很强的预测作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Surgical Oncology 医学-外科

CiteScore

4.70

自引率

4.00%

发文量

367

审稿时长

2 months

期刊介绍： The Journal of Surgical Oncology offers peer-reviewed, original papers in the field of surgical oncology and broadly related surgical sciences, including reports on experimental and laboratory studies. As an international journal, the editors encourage participation from leading surgeons around the world. The JSO is the representative journal for the World Federation of Surgical Oncology Societies. Publishing 16 issues in 2 volumes each year, the journal accepts Research Articles, in-depth Reviews of timely interest, Letters to the Editor, and invited Editorials. Guest Editors from the JSO Editorial Board oversee multiple special Seminars issues each year. These Seminars include multifaceted Reviews on a particular topic or current issue in surgical oncology, which are invited from experts in the field.