Blood-based colorectal cancer screening: are we ready for the next frontier?
Cet article passe en revue les études concernant l'utilisation de l'ADN tumoral circulant dans la prise en charge d'un cancer colorectal
The discovery of circulating and cell-free tumour DNA in the blood has ushered in new possibilities for blood-based colorectal cancer screening. 1 The septin 9 test is currently the only US Federal Drug Administration-approved blood-based colorectal cancer screening test that is available; however, due to its low sensitivity, this test was not included in the 2021 US Preventive Services Task Force Recommendation for colorectal cancer screening. 2 Two other blood-based tests are being developed with the goal of early detection of colorectal cancer or its precursors. One test applies machine learning and multiomics to cell-free DNA (NCT04369053) and the other test uses a multimodal approach to detect circulating tumour DNA (NCT04136002). CancerSEEK (Exact Sciences, WI, US) and Galleri (GRAIL, CA, US) are multicancer early detection tests that have both shown over 80% sensitivity for colorectal cancer in initial studies; 1 Galleri is currently available in the USA, although not reimbursable by insurance. 1 Enthusiasm for the burgeoning collection of non-invasive screening tests has been met at the US federal level. The Centers for Medicare & Medicaid Services has already established predefined metrics for test validity and society endorsements, before extending widespread coverage for blood-based biomarkers. 3 We might be on the brink of a transformative era in colorectal cancer screening, where blood-based testing is poised to disrupt the field.
The Lancet Gastroenterology & Hepatology , commentaire en libre accès, 2022