Circulating tumor DNA (ctDNA) is unreliable for detecting colorectal cancer recurrences after resection, conclude the authors of a review of 48 patients at the City of Hope Comprehensive Cancer Center, outside of Los Angeles.
Two ctDNA tests that are used for this purpose are already marketed in the United States: Signatera (Natera) and Reveal (Guardant Health, Inc).
This use of ctDNA has been catching on with oncologists in the US, note the authors. Such use is based on the premise that the test catches recurrences earlier than imaging and carcinoembryonic antigen (CEA) monitoring, which is the standard approach recommended by the US National Comprehensive Cancer Network (NCCN) and the European Society of Medical Oncology.
The review was published online on March 8 in JAMA Network Open.
The review included 48 patients with stage II–IV colorectal cancer whose disease was in remission after curative-intent surgery. They were followed with CT imaging and CEA, as per NCCN guidelines, and with the Signatera ctDNA test from Natera.
The authors, led by Marwan Fakih, MDa gastrointestinal oncologist at City of Hope, concluded that ctDNA "provides no definitive advantage compared with standard imaging and CEA measurement in the surveillance of patients with resected colorectal cancer."
