![]() ![]() Radiation therapy can improve local recurrence rates in patients with locally advanced rectal cancer (LARC), 1, 2, 3 with preoperative chemoradiation therapy (CRT) considered the standard of care for these patients. Rectal cancer is the second-most common cancer of the large intestine, and a major health burden globally. Serial ctDNA analysis may offer clinically useful predictive and prognostic markers for response to preoperative therapy and postoperative recurrence in patients with LARC. ![]() In addition, postoperative ctDNA and carcinoembryonic antigen (CEA) were independent prognostic markers for risk of recurrence after surgery (ctDNA, P = 0.0127 and CEA, P = 0.0105), with a combined analysis having cumulative effects on recurrence-free survival ( P = 1.0 × 10 –16). Change in ctDNA was an independent predictor of complete response to preoperative therapy ( P = 0.0276). ResultsĬtDNA was detected in 57.6% and 22.3% of samples at baseline and after preoperative treatment, respectively, which was significantly different ( P = 0.0003). MethodsĪ serial ctDNA analysis of 222 plasma samples from 85 patients with LARC was performed using amplicon-based deep sequencing on a cell-free DNA panel covering 14 genes with over 240 hotspots. We analysed the clinical utility of circulating tumour DNA (ctDNA) of patients with LARC to predict response to preoperative therapy and postoperative recurrence. ![]() However, the diagnostic sensitivity of clinical modalities, such as colonoscopy and magnetic resonance imaging to determine pathological response, is not high. The “watch-and-wait” approach is a common treatment option amongst patients with locally advanced rectal cancer (LARC). ![]()
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