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In 230 people whose stage II colon cancer had been removed, finding a trace of tumour DNA in the blood afterwards meant a four in five chance of the cancer coming back, against one in ten if the blood was clear.
Massively parallel sequencing assays were used to evaluate the ability of circulating tumour DNA to detect minimal residual disease in 1,046 plasma samples from a prospective cohort of 230 patients with resected stage II colon cancer. In patients not treated with adjuvant chemotherapy, ctDNA was detected postoperatively in 14 of 178 (7.9%), and 11 of those 14 (79%) had recurred at a median follow-up of 27 months; recurrence occurred in only 16 of 164 (9.8%) with negative ctDNA, giving a hazard ratio of 18. In patients treated with chemotherapy, the presence of ctDNA after completion of chemotherapy was also associated with inferior recurrence-free survival (hazard ratio 11).
It is the founding observation of tumour-informed residual disease testing in solid tumours, and it led directly to DYNAMIC, the randomised trial that made the test change treatment.
Shares Jeanne Tie, Kenneth W. Kinzler, Tumour-informed versus tumour-naive ctDNA assays, ctDNA MRD positivity (molecular residual disease after curative treatment).
Shares Science Translational Medicine, Jeanne Tie, Kenneth W. Kinzler, Peter MacCallum Cancer Centre.
Shares Tumour-informed versus tumour-naive ctDNA assays, Cell-free DNA (cfDNA), ctDNA MRD positivity (molecular residual disease after curative treatment), DYNAMIC.
Shares Jeanne Tie, Kenneth W. Kinzler, Peter MacCallum Cancer Centre, DYNAMIC.
Shares Cell-free DNA (cfDNA), ctDNA MRD positivity (molecular residual disease after curative treatment), Minimal / molecular residual disease (MRD), Circulating tumour DNA (ctDNA).
Shares Science Translational Medicine, ctDNA MRD positivity (molecular residual disease after curative treatment), Minimal / molecular residual disease (MRD), Circulating tumour DNA (ctDNA).
Shares Kenneth W. Kinzler, Cell-free DNA (cfDNA), Bert Vogelstein, Johns Hopkins Hospital / Sidney Kimmel Comprehensive Cancer Center.
Shares Cell-free DNA (cfDNA), ctDNA MRD positivity (molecular residual disease after curative treatment), Johns Hopkins Hospital / Sidney Kimmel Comprehensive Cancer Center, Minimal / molecular residual disease (MRD).