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In an Australian study of patients having surgery for pancreatic cancer, everyone whose blood still held tumour DNA afterwards relapsed, including those who went on to have chemotherapy, which argues for testing whether such patients need more treatment.
Patients considered resectable were enrolled, with pre- and post-operative samples analysed by PCR-based SafeSeqS assays for KRAS codon 12, 13 and 61 mutations in the primary tumour and in plasma; management followed standard care blinded to results. Of 112 consented, 81 (72%) were resected; KRAS mutations were identified in 38 of 42 available tumours (91%). ctDNA was detected in 23 of 37 preoperative (62%) and 13 of 35 postoperative (37%) plasma samples. At a median 38.4 months, preoperative ctDNA predicted inferior recurrence-free (hazard ratio 4.1) and overall survival (4.1); postoperative detection predicted inferior recurrence-free (5.4) and overall survival (4.0). Recurrence occurred in 13 of 13 patients with detectable postoperative ctDNA, including 7 who received gemcitabine-based adjuvant chemotherapy.
Postoperative ctDNA marks a group that current adjuvant chemotherapy does not cure, the rationale for ctDNA-guided intensification trials.
Shares ctDNA MRD positivity (molecular residual disease after curative treatment), Signatera, Minimal / molecular residual disease (MRD), Circulating tumour DNA (ctDNA).
Shares ctDNA MRD positivity (molecular residual disease after curative treatment), Signatera, Minimal / molecular residual disease (MRD), Circulating tumour DNA (ctDNA).
Shares ctDNA MRD positivity (molecular residual disease after curative treatment), Minimal / molecular residual disease (MRD), Circulating tumour DNA (ctDNA), Resectable pancreatic ductal adenocarcinoma.
Shares ctDNA MRD positivity (molecular residual disease after curative treatment), Minimal / molecular residual disease (MRD), Circulating tumour DNA (ctDNA), Resectable pancreatic ductal adenocarcinoma.
Shares ctDNA MRD positivity (molecular residual disease after curative treatment), Signatera, Minimal / molecular residual disease (MRD), Circulating tumour DNA (ctDNA).
Shares Signatera, Minimal / molecular residual disease (MRD), Circulating tumour DNA (ctDNA), MRD / molecular residual disease testing.
Shares ctDNA MRD positivity (molecular residual disease after curative treatment), Minimal / molecular residual disease (MRD), Circulating tumour DNA (ctDNA), MRD / molecular residual disease testing.
Shares Minimal / molecular residual disease (MRD), Circulating tumour DNA (ctDNA), MRD / molecular residual disease testing, Liquid biopsy (ctDNA).