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Dynamics of cell-free tumor DNA correlate with early MRI response during chemoradiotherapy in rectal cancer
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Dynamics of cell-free tumor DNA correlate with early MRI response during chemoradiotherapy in rectal cancer
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Journal Article
Dynamics of cell-free tumor DNA correlate with early MRI response during chemoradiotherapy in rectal cancer
2024
Overview
Background
In locally advanced rectal cancer, the prediction of tumor response during and after neoadjuvant treatment remains challenging. In terms of organ preservation, adaptive radiotherapy, and intensified (total) neoadjuvant therapies, biomarkers are desirable for patient stratification.
Methods
In 16 patients, weekly blood samples (
n
= 86) to detect cell-free tumor DNA (ctDNA) during long-course neoadjuvant chemoradiotherapy were analyzed. Data were correlated with initial tumor volumes, MRI response in week 2 and 5 of radiotherapy as well as with pathologic tumor response after resection and outcome parameters.
Results
Most patients showed decreasing ctDNA during the course of radiochemotherapy. However, we found heterogenous dynamics of ctDNA and could identify three groups: (1) decline (2) no clear decline and/or late shedding (3) persistence of ctDNA. In seven patients we could detect significant amounts of ctDNA in week 5 or week 6 of treatment. In our pilot cohort, we did not find significant correlations of ctDNA dynamics with pathologic response or outcome parameters. However, patients with distinct decline of ctDNA had larger tumor volumes prior to treatment, and MRI imaging in week 2 and 5 revealed bigger absolute decrease of tumor volumes. If significant levels of ctDNA were found in week 5 and / or 6, patients showed less absolute tumor volume decrease in week 2 and 5.
Conclusions
Weekly measurement of ctDNA during radiochemotherapy is feasible and might represent a promising biomarker. Bigger initial primary tumors showed different ctDNA shedding profiles compared with smaller primary tumors and correlations of ctDNA dynamics with early imaging response were found.
Publisher
BioMed Central,BioMed Central Ltd,BMC
Subject
/ Adult
/ Aged
/ Analysis
/ Biomedical and Life Sciences
/ Cancer
/ cfDNA
/ Circulating Tumor DNA - analysis
/ Circulating Tumor DNA - blood
/ ctDNA
/ DNA
/ Ethylenediaminetetraacetic acid
/ Female
/ Humans
/ Imaging
/ Magnetic Resonance Imaging - methods
/ Male
/ Methods
/ NGS
/ Oncology
/ Rectal Neoplasms - diagnostic imaging
/ Rectal Neoplasms - pathology
/ Tumors
