𝐓𝐡𝐞 𝐑𝐨𝐥𝐞 𝐨𝐟 𝐜𝐭𝐃𝐍𝐀 𝐢𝐧 𝐒𝐮𝐫𝐯𝐞𝐢𝐥𝐥𝐚𝐧𝐜𝐞 𝐨𝐟 𝐂𝐨𝐥𝐨𝐫𝐞𝐜𝐭𝐚𝐥 𝐂𝐚𝐧𝐜𝐞𝐫 𝐖𝐞𝐛 𝐒𝐞𝐫𝐢𝐞𝐬

Very excited to have been invited to discuss the role of circulating tumor DNA (ctDNA) in colorectal surveillance for a Cancer Network web series. In CRC ctDNA has proven itself to be a valuable tool for adjuvant therapy decisions and new data continues to emerge of its utility in surveillance. 

At UofL Health we monitor all stage II-IV CRC patients with ctDNA. There is new data presented at ESMO GI that showed metastases-directed therapy rates are significantly higher with ctDNA surveillance than with CEA. While it is observational data and a secondary analysis, this data does help us identify an area of need for future data generation when it comes to identifying metastatic disease early and intervening.

Among patients with colorectal cancer who develop recurrence, over 50% will have metastases to the liver and/or peritoneum. As a hepatobiliary surgical oncologist, a significant portion of my practice is dedicated to the management of patients with metastatic CRC (mCRC) to the liver or peritoneum. Being able to identify clinical recurrence while it is still a solitary lesion or isolated disease increases the amount of treatment options, I have to offer a patient including resection, thermal ablation and Y90. 

Looking ahead to 2026 will be a year of rapid growth and expansion for ctDNA across solid tumors. For years I have been generating observational data in hepatobiliary cancers, including pancreatic adenocarcinoma and liver cancer. These early findings are giving strong signals that ctDNA will inform and hopefully change the way I manage my patients. 

𝐂𝐡𝐞𝐜𝐤 𝐨𝐮𝐭 𝐭𝐡𝐞 𝐰𝐞𝐛 𝐬𝐞𝐫𝐢𝐞𝐬: https://lnkd.in/eWJKcgMF