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Review
. 2024 Jul-Aug;30(4):290-296.
doi: 10.1097/PPO.0000000000000731.

The Role of Circulating Tumor DNA for Management of Patients With Rectal Cancer: Challenges and Opportunities

Ibrahim Halil Sahin  1 , Rami Yanes  1 , Turcin Saridogan  2 , Jennifer Holder-Murray  3 , Arvind N Dasari  4
Affiliations
Review

The Role of Circulating Tumor DNA for Management of Patients With Rectal Cancer: Challenges and Opportunities

Ibrahim Halil Sahin et al. Cancer J. 2024 Jul-Aug.

Abstract

Recently, organ preservation with total neoadjuvant therapy resulted in substantial progress in the management of locally advanced rectal cancer (LARC). The PROSPECT trial showed noninferiority of de-escalation of radiotherapy for patients with low-risk LARC who do not need abdominoperineal resection. Although these escalation and de-escalation approaches offer more personalized therapeutic approaches, the current state of care for patients with rectal cancer is far from individualized management. Circulating tumor DNA (ctDNA) is known to be one of the most powerful prognostic factors for early relapse and has been investigated in several interventional clinical trials to offer more precise treatment algorithms. In this review article, we discuss recent updates from studies examining the role of ctDNA for the prediction of treatment response and recurrence for patients with rectal cancer. We also elaborate on the future potential use of ctDNA in treatment escalation and de-escalation approaches for more personalized therapeutic interventions.

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Conflict of interest statement

Conflicts of Interest and Source of Funding: I.H.S. received advisory board fees in Seattle Genetics, GSK, Guardant Health, and Lumanity and research grants from BAYER and GSK. A.N.D received grants or contracts from HUTCHMED, Guardant Health, Natera, AAA/Novartis, Eisai, and Crinetics and payment or honoraria from HUTCHMED, Personalis, AAA/Novartis, Crinetics, and Voluntis. For the remaining authors, none were declared.

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