Circulating tumor DNA is a prognostic marker of tumor recurrence in stage II and III colorectal cancer: multicentric, prospective cohort study (ALGECOLS)
Year: 2021
Type: article
Study design: Observational Study
Abstract: BACKGROUND: In non-metastatic colorectal cancer (CRC), we evaluated prospectively the pertinence of longitudinal detection and quantification of circulating tumor DNA (ctDNA) as a prognostic marker of recurrence. METHOD: The presence of ctDNA was assessed from plasma collected before and after surgery for 184 patients classified as stage II or III and at each visit during 3-4 years of follow-up. The ctDNA analysis was performed by droplet-based digital polymerase chain reaction, targeting mutation and methylation markers, blindly from the clinical outcomes. Multivariate analyses were adjusted on age, gender, stage, and adjuvant chemotherapy. RESULTS: Before surgery, 27.5% of patients were positive for ctDNA detection. The rate of recurrence was 32.7% and 11.6% in patients with or without detectable ctDNA respectively (P = 0.001). Time to recurrence (TTR) was significantly shorter in patients with detectable ctDNA before (adjusted hazard ratio [HR] = 3.58, 95% confidence interval [CI] 1.71-7.47) or immediately after surgery (adjusted HR = 3.22, 95% CI 1.32-7.89). The TTR was significantly shorter in patients with detectable ctDNA during the early postoperative follow-up (1-6 months) (adjusted HR = 5, 95% CI 1.9-12.9). Beyond this period, ctDNA remained a prognostic marker with a median anticipated diagnosis of recurrence of 13.1 weeks (interquartile range 28 weeks) when compared to imaging follow-up. The rate of ctDNA+ might be underestimated knowing that consensus pre-analytical conditions were not described at initiation of the study. CONCLUSION: This prospective study confirms the relevance of ctDNA as a recurrence risk factor in stage II and III CRC before surgery and as a marker of minimal residual disease after surgery that may predict recurrence several months before imaging techniques.
Source: European Journal of Cancer
Authors: Leonor Benhaim, Olivier Bouché, Corinne Normand, Audrey Didelot, Claire Mulot, Delphine Le Corre, Sonia Garrigou, Juliette Djadi-Prat, Shu-Fang Wang-Renault, Karla Perez-Toralla, Deniz Pekin, Geoffroy Poulet, Bruno Landi, Julien Taieb, Marie Selvy, Jean-Francois Emile, Thierry Lecomte, Helene Blons, Gilles Chatellier, Darren R. Link, Valerie Taly, Pierre Laurent-Puig
Institutions: Centre National de la Recherche Scientifique, Inserm, Université Paris Cité, Institut Gustave Roussy, Sorbonne Université, Centre de Recherche des Cordeliers, La Ligue Contre le Cancer, Fondation Gustave Roussy, Centre Hospitalier Universitaire de Reims, Assistance Publique – Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, Université Paris Descartes, Centre Hospitalier Universitaire de Clermont-Ferrand, Université de Versailles Saint-Quentin-en-Yvelines, Hôpital Ambroise-Paré, Centre Hospitalier Universitaire de Tours, Bio-Rad (United States)
Language: English
Subfield: Cancer Research
Domain: Life Sciences
Open Access status: hybrid
Estimated APC paid: $3,800
Funders: Amgen, Bayer, Merck, Roche, Sanofi, Association pour la Recherche sur le Cancer, Boehringer Ingelheim, Les Laboratories Pierre Fabre, Agence Nationale de la Recherche, Institut National de la Santé et de la Recherche Médicale, Association Nationale de la Recherche et de la Technologie, Ligue Contre le Cancer, Ministère de l'Enseignement Supérieur et de la Recherche, Centre National de la Recherche Scientifique, Université Paris Descartes, Institut National Du Cancer, Servier, Institut Mérieux, Université de Paris, EMD Serono
OpenAlex ID: W3208652244