TY - JOUR
T1 - Post-operative ctDNA monitoring in stage I colon cancer
T2 - A case report
AU - Alden, Stephanie L.
AU - Dhani, Harmeet
AU - Palsuledesai, Charuta C.
AU - Krinshpun, Shifra
AU - Jurdi, Adham
AU - Christenson, Eric
AU - Browner, Ilene
AU - Rosner, Samuel
N1 - Publisher Copyright:
Copyright © 2022 Alden, Dhani, Palsuledesai, Krinshpun, Jurdi, Christenson, Browner and Rosner.
PY - 2022/12/14
Y1 - 2022/12/14
N2 - Circulating tumor DNA (ctDNA) level monitoring after surgery for colon cancer has been studied in stage II and III colon cancer to risk-stratify patients for adjuvant therapy. However, there is less data regarding the role of this diagnostic tool in the management of stage I disease, where current recommended surveillance is limited to screening colonoscopy at one year. In this report, we describe the case of a 57-year-old man with stage I colon cancer who underwent complete resection with adequate lymph node surgical sampling, normal preoperative CEA and no evidence of metastatic disease on initial imaging. The patient elected to undergo serial ctDNA monitoring after surgery. Rising ctDNA levels, five months after resection, prompted cross-sectional imaging which demonstrated metastatic disease to the liver. The patient subsequently received five cycles of leucovorin, 5-fluorouracil, oxaliplatin, and irinotecan with bevacizumab (FOLFOXIRI-Bev) and definitive microwave ablation to the liver metastases, with resulting undetectable ctDNA levels. The patient’s imaging and colonoscopy one-year post-operatively showed no evidence of disease, with ctDNA levels remaining undetectable. This report highlights the value of ctDNA monitoring in patients with early-stage colon cancer and suggests that further, large-scale studies may be warranted to determine its appropriate clinical use.
AB - Circulating tumor DNA (ctDNA) level monitoring after surgery for colon cancer has been studied in stage II and III colon cancer to risk-stratify patients for adjuvant therapy. However, there is less data regarding the role of this diagnostic tool in the management of stage I disease, where current recommended surveillance is limited to screening colonoscopy at one year. In this report, we describe the case of a 57-year-old man with stage I colon cancer who underwent complete resection with adequate lymph node surgical sampling, normal preoperative CEA and no evidence of metastatic disease on initial imaging. The patient elected to undergo serial ctDNA monitoring after surgery. Rising ctDNA levels, five months after resection, prompted cross-sectional imaging which demonstrated metastatic disease to the liver. The patient subsequently received five cycles of leucovorin, 5-fluorouracil, oxaliplatin, and irinotecan with bevacizumab (FOLFOXIRI-Bev) and definitive microwave ablation to the liver metastases, with resulting undetectable ctDNA levels. The patient’s imaging and colonoscopy one-year post-operatively showed no evidence of disease, with ctDNA levels remaining undetectable. This report highlights the value of ctDNA monitoring in patients with early-stage colon cancer and suggests that further, large-scale studies may be warranted to determine its appropriate clinical use.
KW - case report
KW - circulating tumor (ctDNA)
KW - colon cancer
KW - molecular residual disease
KW - recurrence
KW - stage I
UR - http://www.scopus.com/inward/record.url?scp=85145026538&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85145026538&partnerID=8YFLogxK
U2 - 10.3389/fonc.2022.1074786
DO - 10.3389/fonc.2022.1074786
M3 - Article
C2 - 36591529
AN - SCOPUS:85145026538
SN - 2234-943X
VL - 12
JO - Frontiers in Oncology
JF - Frontiers in Oncology
M1 - 1074786
ER -