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引用次数: 0
摘要
综述目的:使用循环肿瘤 DNA (ctDNA) 检测来指导早期结肠癌的临床决策是一个快速发展的活跃研究领域。随着检测方法在临床上的应用,临床医生必须了解如何更好地利用这一新型工具来治疗患者:最近的观察性和前瞻性研究表明,ctDNA 有可能通过检测最小残留病(MRD)和预测复发风险来指导早期结肠癌的临床决策。MRD阴性患者可以降低或放弃辅助化疗(ACT),而不会影响无病生存期或总生存期,而MRD阳性患者则可能从辅助化疗中获益匪浅。最近和正在进行的研究使人们有理由对ctDNA作为临床医生治疗早期结肠癌的有用生物标志物的前景持乐观态度。迄今为止的数据大多局限于观察性研究;不一致的结果凸显了谨慎的必要性。随着更多证据的出现,ctDNA 可能会成为结肠癌患者的标准治疗方法。
Use of Circulating Tumor DNA to Guide Decision-making in Adjuvant Colon Cancer.
Purpose of review: The use of circulating tumor DNA (ctDNA) assays to guide clinical decision-making in early-stage colon cancer is an area of rapidly advancing active research. With assays clinically available, clinicians must be informed how to best use this novel tool to treat patients.
Recent findings: Recent observational and prospective studies have suggested that ctDNA has potential to guide clinical decision-making in early-stage colon cancer by detecting minimal residual disease (MRD) and predicting recurrence risks. MRD-negative patients may be able to de-escalate or forgo adjuvant chemotherapy (ACT) without compromising disease-free survival or overall survival, while MRD-positive patients may benefit significantly from ACT. Recent and ongoing studies have given reason for optimism about the future of ctDNA as a useful biomarker for clinicians treating early-stage colon cancer. Data thus far are mostly limited to observational studies; inconsistent results highlight the need for caution. As more evidence emerges, ctDNA may become standard of care for colon cancer patients.
期刊介绍:
This journal aims to review the most important, recently published clinical findings in the field of oncology. By providing clear, insightful, balanced contributions by international experts, the journal intends to serve all those involved in the care of those affected by cancer.
We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as cancer prevention, leukemia, melanoma, neuro-oncology, and palliative medicine. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.