Eur J Cancer: The clinical benefits of ctDNA as a biomarker for stage 4 colorectal cancer

For patients with metastatic colorectal cancer, strated therapy (surgery or chemotherapy) is usually based on rough clinical pathological characteristics, such as tumor size and number of lesions.
circulating tumor DNA (ctDNA) as a potential biomarker of disease trajectory and biology that can help better stratage colorectal cancer patients.
study aims to systematically assess the ctDNA of stage IV. colorectal cancer to assess its potential role as a potential biomarker to guide treatment planning.
through literature search, screening studies on IV.stage colorectal cancer ctDNA testing and clinical prognostofectomy (radiotherapy response, secondary excision rate, PFS, DFS, or OS).
included 28 studies covering 2,823 patients.
ctDNA can be detected in 80-90% of patients before treatment.
Meta analysis showed a strong correlation between ctDNA detectable after treatment (surgery or chemotherapy) and total lifetime (risk ratio of HR 2.2) and progressive survival (HR 3.15).
CtDNA has always been an early sign of long-term prognostication in cancer patients who cannot be surgically removed;
test ctDNA detected recurrence 10 months earlier than imaging in patients with an intention to treat and who could be surgically removed.
, ctDNA is detectable in most patients with removable and unsectionable tumors.
the presence of ctDNA is significantly associated with a shorter total lifetime, and changes in ctDNA are early biomarkers of bad disease behavior.
-forward trials are the key to testing their clinical benefits.