Practical Guide to Interpreting ctDNA in Gastrointestinal Cancer Management
This Clinical Chemistry review provides a practical framework for clinicians interpreting ctDNA results across colorectal, esophagogastric, and pancreatic cancers, addressing specimen collection, processing, and analytical considerations that affect reporting. The authors evaluate current evidence for ctDNA in screening, molecular residual disease detection, surveillance for recurrence, therapy response assessment, and guiding targeted therapy. While results are promising, the review highlights that larger prospective trials and standardized collection and reporting protocols are needed for wider clinical adoption.
The original study
A Practical Approach to Interpreting Circulating Tumor DNA in the Management of Gastrointestinal Cancers.
- Authors
- Allan Z, Liu DS, Lee MM, Tie J, Clemons NJ
- Journal
- Clinical chemistry
- Type
- Review, Journal Article
- PMID
- 38175583
Original abstract
BACKGROUND: There is accumulating evidence supporting the clinical use of circulating tumor DNA (ctDNA) in solid tumors, especially in different types of gastrointestinal cancer. As such, appraisal of the current and potential clinical utility of ctDNA is needed to guide clinicians in decision-making to facilitate its general applicability. CONTENT: In this review, we firstly discuss considerations surrounding specimen collection, processing, storage, and analysis, which affect reporting and interpretation of results. Secondly, we evaluate a selection of studies on colorectal, esophago-gastric, and pancreatic cancer to determine the level of evidence for the use of ctDNA in disease screening, detection of molecular residual disease (MRD) and disease recurrence during surveillance, assessment of therapy response, and guiding targeted therapy. Lastly, we highlight current limitations in the clinical utility of ctDNA and future directions. SUMMARY: Current evidence of ctDNA in gastrointestinal cancer is promising but varies depending on its specific clinical role and cancer type. Larger prospective trials are needed to validate different aspects of ctDNA clinical utility, and standardization of collection protocols, analytical assays, and reporting guidelines should be considered to facilitate its wider applicability.