Circulating Tumour DNA and Colorectal Cancer: the Next Revolutionary Biomarker?

Purpose of Review Improving outcomes for patients with colorectal cancer in both the adjuvant and metastatic setting has been challenging. Here, we review the current and future directions for using ctDNA in clinical practice. Recent Findings Circulating tumour DNA (ctDNA) with its ability to detect minimal residual disease is beginning to refine the way we assess recurrence risk in the adjuvant setting. We can potentially tailor treatments to reduce recurrence risk and minimize treatment toxicity. In the metastatic setting, ctDNA can provide a less invasive method of detecting clinically important genetic changes to guide molecularly targeted treatment and to identify mechanisms of molecular resistance. ctDNA can be a surrogate marker for treatment response and help guide the timing of anti-EGFR rechallenge. We await the results of the randomized clinical trials assessing clinical utility of ctDNA in both the adjuvant and metastatic setting before incorporating ctDNA into clinical practice.

Automated summary

The use of ctDNA in colorectal cancer treatment shows potential in individualizing treatment, guiding targeted therapy selection, and providing a surrogate marker for treatment response. The results of randomized clinical trials will determine if ctDNA can be truly incorporated into clinical practice in the future.