Health
Blood test may determine CRC patients needing chemotherapy after surgery
According to a recent study published in , blood test results could show which colorectal cancer patients are at risk of recurrence after surgery, should undergo chemotherapy, and which patients can skip it. It might help. natural medicine.
Researchers measured circulating tumor DNA (ctDNA), cancer DNA found in the bloodstream, in 1,039 patients with stage 2 to stage 4 resectable colorectal cancer. Examination of ctDNA levels before and after resection (surgical resection of cancer) showed that ctDNA positivity 4 weeks after surgery was associated with an increased risk of disease recurrence and was the most important prognostic factor in stage 2 or 3 colorectal patients. Cancer that has been shown to exist.
“except Bluff When Russ We observed that ctDNA was the most important risk factor for recurrence,” the researchers wrote. “This is due to the fact that ctDNA-positive patients with stage 1 and low-risk stage 2 (colorectal cancer) 4 weeks after surgery have significantly higher recurrence rates than ctDNA-negative patients with oligometastatic resection (colorectal cancer). has been proven by.”
Furthermore, the findings also showed that ctDNA positivity identifies which stage 2 or 3 patients would benefit from postoperative chemotherapy.
Currently, clinicians use multiple factors such as stage, tumor size, and lymphovascular invasion (presence of cancer in the lymphatic or vascular system) to require patients to receive postoperative chemotherapy I’m judging whether
Now researchers hope these findings will support the use of ctDNA measurements in treatment decision criteria. can also save the patient from Inconsistent.
Overall, the addition of this chemotherapy has been shown to improve progression-free survival (time from treatment to disease progression), although this is often associated with overall survival (time from treatment to death). It doesn’t lead to improvement.
“Standard[postoperative chemotherapy]is associated with side effects, including oxaliplatin-induced, and reportedly only reduces the absolute recurrence rate by 10-15% in the overall population with clinicopathological risk factors. It has been. peripheral neuropathy’” wrote the researcher. “Clinically, however, decisions to administer[postoperative chemotherapy]are often weighed against factors such as patient preference, patient performance status, and clinical risk of recurrence.”
The researchers also explained that postoperative treatment for ctDNA-positive patients may be beneficial, as seen in the Phase 3 IMvigor010 trial. Tecentriq (atezolizumab) was administered. However, the patient who was ctDNA negative after surgery had no benefit from Tecentriq.
“…strong evidence of a similar relationship must be taken into account, where similar trends reported in urothelial carcinoma support our results,” the researchers wrote.
Ongoing research is currently being conducted on how to best use ctDNA in patients with colorectal cancer.
“An ongoing prospective randomized trial will further investigate the optimal ctDNA-guided treatment strategy for surgically resectable CRC,” they wrote.
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