Liquid Biopsy Assessment of Molecular Residual Disease in Localized Colorectal Cancer: Is It Ready for Prime Time?
Menée à partir d'échantillons sanguins prélevés sur 350 patients atteints d'un cancer colorectal de stade I à III (âge moyen : 60 ans ; 62 % d'hommes), cette étude multicentrique évalue l'association entre 6 marqueurs de la méthylation de l'ADN tumoral circulant et le risque de récidive
Colorectal cancer is the third most common cancer diagnosed in the US, with 52 550 estimated cancer deaths in 2023. Presently, surgery remains the main treatment for patients with localized colorectal cancer (CRC). Additionally, some patients benefit from using adjuvant chemotherapy to treat clinically undetectable micrometastatic lesions that could lead to subsequent disease recurrence. In patients with stage III CRC, adjuvant chemotherapy decreases the probability of cancer recurrence by approximately 10% to 20%, depending on the treatment regimen selected. In contrast, in stage II CRC, the role of adjuvant chemotherapy remains debatable. In this regard, the National Comprehensive Cancer Network–Colon Cancer guidelines state that “it is reasonable to accept the relative benefit of adjuvant therapy in stage III disease as indirect evidence of benefit for stage II disease, especially for those with high-risk features.” The key clinicopathological features associated with a high risk of disease recurrence include poorly differentiated or undifferentiated histologic examination findings, lymphatic or vascular invasion, bowel obstruction, less than 12 lymph nodes examined, perineural invasion, localized perforation, or close, indeterminate, positive margins, and more recently, tumor budding.
JAMA Oncology , éditorial, 2022