Circulating Tumor DNA Detects Minimal Residual Disease in Patients with Locally Advanced Rectal Cancer After Total Neoadjuvant Therapy
Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Patients
2.2. Response Assessments
2.3. Local Regrowth
2.4. ctDNA Testing
2.5. Statistical Analysis
3. Results
3.1. Patient Groups by ctDNA Positivity
3.2. ctDNA Can Potentially Detect MRD in the Rectum in Patients Under Watch-and-Wait Protocol After TNT
3.3. Potential Role of ctDNA in Detecting Distant Metastases
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
TNT | Total neoadjuvant therapy; |
LARC | Locally advanced rectal cancer; |
NOM | Non-operative management; |
TME | Total mesorectal excision; |
ctDNA | Circulating tumor DNA; |
MRD | Minimally residual disease; |
MMR | Mismatch repair; |
LE | Local excision; |
pCR | Pathologic complete response; |
IRB | Institutional review board; |
cCR | Complete clinical response; |
nCR | Near complete response; |
iCR | Incomplete response. |
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ctDNA-Positive | ctDNA-Negative | p-Value | |
---|---|---|---|
Number of patients | 9 | 19 | |
Age (years) (mean, std dev) | 60 (11) | 66 (12) | 0.25 |
Sex (N, %) | >0.9 | ||
Male | 5 (56%) | 12 (63%) | |
Female | 4 (44%) | 7 (37%) | |
cT (N, %) | 0.21 | ||
2 | 1 (11%) | 1 (5%) | |
3 | 6 (67%) | 17 (90%) | |
4 | 2 (22%) | 1 (5%) | |
cN (N, %) | 0.65 | ||
0 | 2 (22%) | 6 (32%) | |
1 | 6 (67%) | 9 (47%) | |
2 | 1 (11%) | 4 (21%) | |
MMR status (N, %) | >0.9 | ||
MMR-proficient | 8 (89%) | 16 (84%) | |
MMR-deficient | 0 (0%) | 1 (5%) | |
Unknown | 1 (11%) | 2 (11%) | |
Tumor distance (cm) (mean, std) | 5.7 (3.8) | 5.9 (4.2) | 0.84 |
Total neoadjuvant therapy (N, %) | 9 (100%) | 19 (100%) | >0.9 |
Local Regrowth (N, %) | 6 (66%) | 4 (21%) | 0.035 |
Definitive treatment of primary tumor (N, %) | 0.041 | ||
LE | 2 (22%) | 0 (0%) | |
TME | 4 (44%) | 4 (21%) | |
NOM | 3 (33%) | 14 (74%) | |
Median follow-up (years) | 1.81 | 1.47 | 0.72 |
Distant recurrence (N, %) | 2 (22%) | 1 (5%) | 0.23 |
Local recurrence (N, %) | 0 (0%) | 0 (0%) | |
Resection Pathology (N) | 6 | 4 | |
pCR | 0 (0%) | 1 (25%) | |
Residual tumor | 6 (100%) | 3 (75%) |
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Kim, J.K.; Alden, A.J.; Knaus, S.; Thakkar, R.; Moudgill, L.; Chudzinski, A.; Cavallaro, P.; Martinez, C.; Bennett, R.D.; Marcet, J. Circulating Tumor DNA Detects Minimal Residual Disease in Patients with Locally Advanced Rectal Cancer After Total Neoadjuvant Therapy. Cancers 2025, 17, 2560. https://doi.org/10.3390/cancers17152560
Kim JK, Alden AJ, Knaus S, Thakkar R, Moudgill L, Chudzinski A, Cavallaro P, Martinez C, Bennett RD, Marcet J. Circulating Tumor DNA Detects Minimal Residual Disease in Patients with Locally Advanced Rectal Cancer After Total Neoadjuvant Therapy. Cancers. 2025; 17(15):2560. https://doi.org/10.3390/cancers17152560
Chicago/Turabian StyleKim, Jin K., Ashley J. Alden, Sarah Knaus, Rishabh Thakkar, Lisa Moudgill, Allen Chudzinski, Paul Cavallaro, Carolina Martinez, Robert D. Bennett, and Jorge Marcet. 2025. "Circulating Tumor DNA Detects Minimal Residual Disease in Patients with Locally Advanced Rectal Cancer After Total Neoadjuvant Therapy" Cancers 17, no. 15: 2560. https://doi.org/10.3390/cancers17152560
APA StyleKim, J. K., Alden, A. J., Knaus, S., Thakkar, R., Moudgill, L., Chudzinski, A., Cavallaro, P., Martinez, C., Bennett, R. D., & Marcet, J. (2025). Circulating Tumor DNA Detects Minimal Residual Disease in Patients with Locally Advanced Rectal Cancer After Total Neoadjuvant Therapy. Cancers, 17(15), 2560. https://doi.org/10.3390/cancers17152560