Onkológia 1/2025
Possibilities of using circulating tumor DNA in the adjuvant treatment of colorectal cancer
Circulating tumor DNA (ctDNA) is a significant biomarker in personalized adjuvant treatment of colorectal cancer. The use of ctDNA enables the early detection of minimal residual disease, which is associated with an increased risk of recurrence. Studies such as BESPOKE and GALAXY have demonstrated that positive ctDNA detection after surgery is a strong predictor of CRC recurrence and can serve as a guide for decisionmaking regarding adjuvant chemotherapy administration. Despite promising results, the COBRA study has shown that using ctDNA as the sole criterion for adjuvant treatment indication may be limited. Currently, ctDNA testing is not included in the routine recommendations of the American Society of Clinical Oncology (ASCO) or the European Society for Medical Oncology (ESMO). In the future, research is expected to focus on integrating ctDNA into clinical practice to minimize overtreatment while ensuring appropriate therapy for patients at increased risk of relapse.
Keywords: circulating tumor DNA, biomarker, colorectal cancer, adjuvant treatment
