ctDNA Positivity Appears to Predict Risk of Recurrence, Benefit from Adjuvant Chemotherapy in Resectable CRC

Video

An expert from Natera discusses ctDNA’s predictive and prognostic value in resectable colorectal cancer based on data from the GALAXY cohort of the CIRCULATE-JAPAN platform study.

Post-surgical circulating tumor DNA (ctDNA) level in patients with colorectal cancer (CRC) appeared to effectively predict disease recurrence as well as potential benefit from adjuvant chemotherapy, according to Minetta Liu, MD, chief medical officer of oncology at Natera.

CancerNetwork® spoke with Liu in an interview regarding efficacy findings from the observational GALAXY arm of the CIRCULATE-Japan platform study.

In the GALAXY cohort, post-surgical ctDNA detection 4 weeks following surgery was associated with a higher risk of recurrence (HR, 10.0; P <.0001) and helped to identify patients with stage II or III disease who derived benefit from adjuvant chemotherapy (HR, 6.59; P <.0001).

She also went to describe limitations for the research that should be addressed by ongoing randomized clinical research.

Transcript:

CIRCULATE-JAPAN, just to put this in context, is an adaptive platform with 3 clinical trials, and GALAXY represents the observational arm of that platform study. With this long median follow-up of 16.74 months, we demonstrated that that post-surgical time point at 4 weeks, that ctDNA positivity by [the] Signatera [assay] can be used to represent the higher risk of recurrence, but more importantly, predict benefit from adjuvant chemotherapy.

The major limitation is the simple fact that it's an observational study. This was non-interventional, although physicians were prescribing therapy based on their assessments of what patients’ risk of recurrence. But this [should] be supported by ongoing randomized clinical trials demonstrating utility.

Reference

Kotani D, Oki E, Nakamura Y, et al. Molecular residual disease and efficacy of adjuvant chemotherapy in patients with clinical stage II-IV resectable colorectal cancer. Nature Medicine. Published online January 16, 2023. doi:10.1038/s41591-022-02115-4

Newsletter

Stay up to date on recent advances in the multidisciplinary approach to cancer.

Recent Videos
Treatment with KRAS inhibitors may help mitigate a common driver of genetic alteration across a majority of pancreatic cancers.
Updated results from the BREAKWATER study seemed to be most impactful to the CRC space, according to Michael J. Pishvaian, MD, PhD.
Future research will aim to assess the efficacy of PIPAC-MMC plus systemic therapy vs systemic therapy alone in patients with peritoneal tumors.
Although small incision surgery may serve as a conduit to deliver PIPAC-MMC, it may confer benefits in the staging and treatment of peritoneal tumors.
Patients with peritoneal metastases were historically associated with limited survival and low consideration for clinical trials.
Combining sotorasib with panitumumab may reduce the burden of disease in patients with KRAS G12C-mutated metastatic colorectal cancer.
Findings from the CodeBreak 300 study have cemented sotorasib/panitumumab as a third-line treatment option for KRAS G12C-mutated colorectal cancer.
Sotorasib plus panitumumab may offer improved survival compared with previously approved treatment options in KRAS G12C-mutated colorectal cancer.
Additional local, regional, or national policy may bolster access to screening for colorectal cancer, according to Aasma Shaukat, MD, MPH.
Related Content