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Editor’s note iNature is China’s largest academic official account.
It is jointly created by the doctoral team of Tsinghua University, Harvard University, Chinese Academy of Sciences and other units.
The iNature Talent Official Account is now launched, focusing on talent recruitment, academic progress, scientific research information, and interested parties Long press or scan the QR code below to follow us.
Tumor recurrence after radical resection of iNature's early to mid-stage bowel cancer often leads to poor prognosis.
Adjuvant chemotherapy three to six months after surgery is an effective means to reduce recurrence.
However, adjuvant treatment decisions based on clinicopathological risk factors under current standards often lead to over or under treatment, and there is an urgent need for more accurate postoperative recurrence risk stratification tools.
On May 17, 2021, Professor Xu Ruihua and Professor Wang Feng from the Cancer Center of Sun Yat-sen University, Professor Cai Sanjun from Fudan University Cancer Hospital and Professor Ding Kefeng from the Second Affiliated Hospital of Zhejiang University School of Medicine were online in the Journal of Hematology & Oncology (IF=11.
06) Published a research paper entitled "Postoperativecirculating tumor DNA as markers of recurrence risk in stages II to IIIcolorectal cancer", the multicenter team carried out a prospective, observational cohort study to explore the early prediction of blood circulating tumor DNA (ctDNA) The role of mid-stage colorectal cancer in the risk of recurrence after radical resection.
The study found that in early and mid-stage colorectal cancer patients, postoperative ctDNA-positive patients have a significantly higher risk of recurrence than ctDNA-negative patients, and that dynamic ctDNA detection can predict tumor recurrence an average of 5.
01 months earlier than conventional imaging methods such as CT scans.
ctDNA detection is expected to be used to guide accurate decision-making and follow-up monitoring of postoperative adjuvant treatment.
Colorectal cancer (CRC) is the third most common cancer in the world, with more than 1.
9 million new cases each year.CRC is also the second leading cause of cancer-related deaths, and its 5-year mortality rate is about 40%.
It is also a huge public health burden in my country.
Through serum carcinoembryonic antigen (CEA) and colonoscopy screening, we are now increasingly able to diagnose bowel cancer before it has metastasized.
For these patients, surgical resection is the best treatment.
However, a considerable number of patients still have recurrence and metastasis after radical resection.
Early and mid-stage bowel cancer surgery faces two major problems: how to identify patients at high risk of recurrence in order to make accurate decision-making aids? How to detect tumor recurrence earlier for timely intervention? In recent years, blood circulating tumor DNA (ctDNA) detection technology has become more and more perfect, and has great application potential in identifying patients with high recurrence risk and early warning of tumor recurrence, but there is still a lack of high-quality evidence-based medical evidence.
A multi-center research team from Sun Yat-sen University Cancer Center, Fudan University Tumor Hospital, and the Second Affiliated Hospital of Zhejiang University School of Medicine conducted a prospective, observational cohort study.
The study included 240 patients with stage II/III colorectal cancer who underwent radical surgery, and blood samples were collected within one week before surgery, 3-7 days after surgery, and 6 to 24 months after surgery (once every three months) , Carrying out dynamic blood ctDNA test (provided for free by Nanjing Shihe Gene Biotechnology Company), aiming to explore whether the ctDNA test can screen patients with high risk of recurrence and early warning of tumor recurrence.
The results of this study showed that the risk of recurrence of ctDNA-positive patients 3-7 days after surgery was significantly higher than that of ctDNA-negative patients (Figure a).
After receiving conventional adjuvant therapy, ctDNA testing was performed, and ctDNA positive still indicated a significantly higher risk of recurrence (Figure b).
The above results indicate that ctDNA testing can well indicate the risk of recurrence, whether before the start of adjuvant therapy or after the completion of adjuvant therapy, so it is expected to guide precise treatment decisions after surgery and after adjuvant therapy.
Further dynamic ctDNA test results show that during the disease recurrence monitoring stage (radical resection or radical resection + adjuvant therapy), the risk of recurrence of patients with positive dynamic ctDNA test is significantly higher than that of patients with negative ctDNA (Figure c), and ctDNA can be routinely imaged in advance An average of 5.
01 months for early warning of tumor recurrence (Figure d) provides the possibility of early detection and timely intervention of disease recurrence.
a.
Detected 3-7 days after the operation, the tumor recurrence rate of ctDNA-positive patients is significantly higher than that of ctDNA-negative patients.
b.
After completing the adjuvant treatment, the tumor recurrence rate of ctDNA-positive patients is still significantly higher than that of ctDNA-negative patients.
c.
During the follow-up observation period, the tumor recurrence rate of patients with positive dynamic ctDNA test was significantly higher than that of patients with negative ctDNA.
d.
Dynamic ctDNA detection can warn tumor recurrence in an average of 5.
01 months earlier than conventional imaging methods such as CT examination.
In short, the study confirmed that ctDNA can be used to predict the risk of recurrence of colon cancer after surgery, and the risk of tumor recurrence in patients with positive ctDNA after surgery is significantly increased.
Accurate adjuvant treatment strategies based on the guidance of ctDNA testing will likely rewrite the current guidelines and standards in the future.
Professor Ruihua Xu and Professor Wang Feng from Sun Yat-sen University Cancer Center, Professor Cai Sanjun from Fudan University Cancer Hospital, and Professor Ding Kefeng from the Second Affiliated Hospital of Zhejiang University School of Medicine are the co-corresponding authors; Professor Chen Gong (Zhong Zhong) and Professor Peng Junjie ( Fudan University Cancer Hospital), Professor Xiao Qian (The Second Affiliated Hospital of Zhejiang University School of Medicine), and Dr.
Wu Haoxiang (Zhongzhong) are the co-first authors of the paper.
Reference message: https://jhoonline.
biomedcentral.
com/articles/10.
1186/s13045-021-01089-z
It is jointly created by the doctoral team of Tsinghua University, Harvard University, Chinese Academy of Sciences and other units.
The iNature Talent Official Account is now launched, focusing on talent recruitment, academic progress, scientific research information, and interested parties Long press or scan the QR code below to follow us.
Tumor recurrence after radical resection of iNature's early to mid-stage bowel cancer often leads to poor prognosis.
Adjuvant chemotherapy three to six months after surgery is an effective means to reduce recurrence.
However, adjuvant treatment decisions based on clinicopathological risk factors under current standards often lead to over or under treatment, and there is an urgent need for more accurate postoperative recurrence risk stratification tools.
On May 17, 2021, Professor Xu Ruihua and Professor Wang Feng from the Cancer Center of Sun Yat-sen University, Professor Cai Sanjun from Fudan University Cancer Hospital and Professor Ding Kefeng from the Second Affiliated Hospital of Zhejiang University School of Medicine were online in the Journal of Hematology & Oncology (IF=11.
06) Published a research paper entitled "Postoperativecirculating tumor DNA as markers of recurrence risk in stages II to IIIcolorectal cancer", the multicenter team carried out a prospective, observational cohort study to explore the early prediction of blood circulating tumor DNA (ctDNA) The role of mid-stage colorectal cancer in the risk of recurrence after radical resection.
The study found that in early and mid-stage colorectal cancer patients, postoperative ctDNA-positive patients have a significantly higher risk of recurrence than ctDNA-negative patients, and that dynamic ctDNA detection can predict tumor recurrence an average of 5.
01 months earlier than conventional imaging methods such as CT scans.
ctDNA detection is expected to be used to guide accurate decision-making and follow-up monitoring of postoperative adjuvant treatment.
Colorectal cancer (CRC) is the third most common cancer in the world, with more than 1.
9 million new cases each year.CRC is also the second leading cause of cancer-related deaths, and its 5-year mortality rate is about 40%.
It is also a huge public health burden in my country.
Through serum carcinoembryonic antigen (CEA) and colonoscopy screening, we are now increasingly able to diagnose bowel cancer before it has metastasized.
For these patients, surgical resection is the best treatment.
However, a considerable number of patients still have recurrence and metastasis after radical resection.
Early and mid-stage bowel cancer surgery faces two major problems: how to identify patients at high risk of recurrence in order to make accurate decision-making aids? How to detect tumor recurrence earlier for timely intervention? In recent years, blood circulating tumor DNA (ctDNA) detection technology has become more and more perfect, and has great application potential in identifying patients with high recurrence risk and early warning of tumor recurrence, but there is still a lack of high-quality evidence-based medical evidence.
A multi-center research team from Sun Yat-sen University Cancer Center, Fudan University Tumor Hospital, and the Second Affiliated Hospital of Zhejiang University School of Medicine conducted a prospective, observational cohort study.
The study included 240 patients with stage II/III colorectal cancer who underwent radical surgery, and blood samples were collected within one week before surgery, 3-7 days after surgery, and 6 to 24 months after surgery (once every three months) , Carrying out dynamic blood ctDNA test (provided for free by Nanjing Shihe Gene Biotechnology Company), aiming to explore whether the ctDNA test can screen patients with high risk of recurrence and early warning of tumor recurrence.
The results of this study showed that the risk of recurrence of ctDNA-positive patients 3-7 days after surgery was significantly higher than that of ctDNA-negative patients (Figure a).
After receiving conventional adjuvant therapy, ctDNA testing was performed, and ctDNA positive still indicated a significantly higher risk of recurrence (Figure b).
The above results indicate that ctDNA testing can well indicate the risk of recurrence, whether before the start of adjuvant therapy or after the completion of adjuvant therapy, so it is expected to guide precise treatment decisions after surgery and after adjuvant therapy.
Further dynamic ctDNA test results show that during the disease recurrence monitoring stage (radical resection or radical resection + adjuvant therapy), the risk of recurrence of patients with positive dynamic ctDNA test is significantly higher than that of patients with negative ctDNA (Figure c), and ctDNA can be routinely imaged in advance An average of 5.
01 months for early warning of tumor recurrence (Figure d) provides the possibility of early detection and timely intervention of disease recurrence.
a.
Detected 3-7 days after the operation, the tumor recurrence rate of ctDNA-positive patients is significantly higher than that of ctDNA-negative patients.
b.
After completing the adjuvant treatment, the tumor recurrence rate of ctDNA-positive patients is still significantly higher than that of ctDNA-negative patients.
c.
During the follow-up observation period, the tumor recurrence rate of patients with positive dynamic ctDNA test was significantly higher than that of patients with negative ctDNA.
d.
Dynamic ctDNA detection can warn tumor recurrence in an average of 5.
01 months earlier than conventional imaging methods such as CT examination.
In short, the study confirmed that ctDNA can be used to predict the risk of recurrence of colon cancer after surgery, and the risk of tumor recurrence in patients with positive ctDNA after surgery is significantly increased.
Accurate adjuvant treatment strategies based on the guidance of ctDNA testing will likely rewrite the current guidelines and standards in the future.
Professor Ruihua Xu and Professor Wang Feng from Sun Yat-sen University Cancer Center, Professor Cai Sanjun from Fudan University Cancer Hospital, and Professor Ding Kefeng from the Second Affiliated Hospital of Zhejiang University School of Medicine are the co-corresponding authors; Professor Chen Gong (Zhong Zhong) and Professor Peng Junjie ( Fudan University Cancer Hospital), Professor Xiao Qian (The Second Affiliated Hospital of Zhejiang University School of Medicine), and Dr.
Wu Haoxiang (Zhongzhong) are the co-first authors of the paper.
Reference message: https://jhoonline.
biomedcentral.
com/articles/10.
1186/s13045-021-01089-z
