Circulating Tumor DNA as a Minimal Residual Disease Assessment and Recurrence Risk in Patients Undergoing Curative-Intent Resection with or without Adjuvant Chemotherapy in Colorectal Cancer: A Systematic Review and Meta-Analysis
and Anup Kasi 1,*,§Round 1
Reviewer 1 Report
The manuscript focuses on meta-analysis of literature data about the role of liquid biopsy for MRD evaluation in CRC patients. Accordingly, several minor integrations should be approached to improve the readibilty of this manuscript.
- Introduction section: the authors clearly define the clinical setting where they moved on
- Material and methods sections are adequately investigated by the authors.
-Results section: please, could the authors consider other variables, such as number of timing collected samples, clinical stages as variables that could impact on the results?. Table 1 appears confusing and not meaningfull. Please, could the authros review this part?
- Discussion section, please, could the authors discuss about the critical issues related to the implementation of liquid biopsy for MRD evaluation
Minor english modifications should be promoted
Author Response
Please see the attachment.
Thank you.
Reviewer 2 Report
This is an interesting study, but, to my opinion, it may benefit from better emphasis. It should be stressed that ctDNA studies on surgically treated colorectal carcinomas have excellent reproducibility. Furthermore, clinical studies already suggested that stage II post-surgery ctDNA-negative colon cancer patients may be spared from adjuvant therapy [Tie et al. Circulating Tumor DNA Analysis Guiding Adjuvant Therapy in Stage II Colon Cancer. N Engl J Med. 2022 Jun 16;386(24):2261-2272]. The authors perform comprehensive analysis, which indicates that tumor-informed ctDNA analysis may be more reliable than the tumor-agnostic one. Perhaps, post-surgical ctDNA analysis may have different prognostic reliability in patients of different stages. It would be important for readers, if the Discussion / Conclusions will draw some recommendations for design of future ctDNA clinical studies, which will aim at defining criteria for the abstinence of adjuvant therapy.
Please avoid abbreviation (MRD) in the title.
Please explain “tumor-informed” and “tumor-agnostic” in the Abstract.
Author Response
Please see the attachment
Thank you.
Author Response File: 
Author Response.docx
