![]() ![]() ![]() The ability to use ctDNA to identify patients with MRD has important clinical relevance in CRC for several reasons. 5 ctDNA has been widely studied for MRD detection in CRC to aid in clinical decision-making. 3,4 ctDNA is shed from either a primary tumor or metastatic site via secretion, apoptosis, or necrosis into the bloodstream, where it can subsequently be collected by venous sampling. ![]() ![]() With increasingly widespread availability of genomic sequencing methods and subsequent greater sensitivity in detecting microscopic disease in peripheral blood, significant research has been focused on utilizing this capability to improve outcomes in CRC, particularly after curative resection.Ī term initially coined in the context of hematologic malignancies after induction therapy, molecular residual disease (MRD)-sometimes also referred to as “minimal residual disease “in solid tumors-is defined as molecular evidence of disease detected via cell-free circulating tumor DNA (ctDNA) or another tumor-derived moiety, in the absence of radiographically evident disease. 2 However, this risk stratification is incomplete. The clinical decision regarding use of adjuvant therapy has been based on lymph node status and other clinic pathological risk factors (eg grade or presence of obstruction or perforation). 1 Traditionally, treatment and prognostication have been based on American Joint Committee on Cancer tumor–node-metastasis staging, relying on the extent of radiographically evident disease locoregional disease is treated primarily with surgery, with or without adjuvant chemotherapy, and metastatic disease is primarily treated with systemic therapy. Colorectal cancer (CRC) remains the third most common cancer and second most common cause of cancer death in the United States. ![]()
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March 2023
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