Colorectal cancer detected by liquid biopsy 2 years prior to clinical diagnosis in the HUNT study
Menée en Norvège à l'aide d'échantillons plasmatiques prélevés sur 106 témoins sains et 106 patients atteints d'un cancer colorectal diagnostiqué dans les 24 mois qui suivent leur participation à un programme de dépistage, cette étude identifie au niveau de l'ADN tumoral circulant un panel de 8 gènes méthylés permettant de détecter précocement la maladie
Background : Colorectal cancer (CRC) is often diagnosed in advanced stages. Circulating tumour DNA (ctDNA) has been proposed as an early diagnostic biomarker. However, as a screening tool, ctDNA has mainly been studied in selected populations at the time of clinical diagnosis. The aim of this study was to detect CRC by known ctDNA markers up to 2 years prior to clinical diagnosis.
Methods : In this case–control study, methylated ctDNA markers were detected in plasma samples from 106 healthy controls and 106 individuals diagnosed with CRC within 24 months following participation in The Trøndelag Health Study.
Results : The most specific single markers were BMP3, FLI1, IKZF1, SFRP1, SFRP2, NPTX2, SLC8A1 and VIM (specificity >70%). When combining these into a panel, the CRC sensitivity was 43% (95% CI 42.7–43.4) and the CRC specificity was 86% (95% CI 85.7–86.2). The findings were reproduced in an independent validation set of samples.
Conclusions : Detection of known methylated ctDNA markers of CRC is possible up to 2 years prior to the clinical diagnosis in an unselected population resembling the screening setting. This study supports the hypothesis that some patients could be diagnosed earlier, if ctDNA detection was part of the CRC screening programme.
British Journal of Cancer , article en libre accès, 2023