[Clinical Utility of Circulating Tumor DNA Analysis for Precision Medicine in Patients with Advanced Gastrointestinal Cancer]

Abstract

To implement cancer precision medicine based on genomic alterations, tumor tissue genomic profiling using next generation sequencing(NGS)has been reimbursed in 2019, resulting in simultaneous measurement of multiple biomarkers and genomic abnormalities in clinical practice in Japan. However, NGS analysis of tumor tissue has several limitations, including long turnaround time, and difficulty in capturing heterogeneity and longitudinal genotyping. Recently, liquid biopsy has been developed to assess tumor status by analyzing body fluids, such as blood and urine, without the use of tumor tissue. In particular, analysis of circulating tumor DNA(ctDNA)is one of the most advanced technique for liquid biopsy in the world. Our study demonstrated that ctDNA analysis led the shorter turnaround time and acceleration of the trial enrollment in advanced gastrointestinal cancer compared to tissue analysis. Tissue and ctDNA analysis need to be used based on the characteristics of both assays in cancer precision medicine for patients with advanced gastrointestinal cancer in the future.