Circulating tumour DNA in patients with stage III colon cancer: multicentre prospective PROVENC3 study

Summary

Colon cancer can recur after surgery. Doctors need better tools to identify who is most at risk. A new test can find small fragments of DNA from the tumour that circulate in blood, called ctDNA. If ctDNA is detected in the blood, it means that some cancer cells remained in the body after surgery. The study investigated whether finding ctDNA in the blood could predict the chance of colon cancer reappearing in patients with localized (stage III) disease who were treated with chemotherapy. Blood samples were collected from 209 patients after surgery. The samples were tested for ctDNA presence using a novel and very sensitive assay. Patients were followed for about 3 years. Patients with ctDNA detected in their blood after surgery were more likely to see their cancer reappear compared with patients without ctDNA detected. However, not all patients with ctDNA present experienced disease recurrence, suggesting they benefitted from chemotherapy. The combination of ctDNA test results with other risk factors, such as tumour size and lymph node involvement, gave an even clearer picture of an individual’s risk of disease recurrence. This study concluded that finding ctDNA after surgery helps to identify patients at high risk of disease recurrence. This test could guide doctors to offer closer follow-up or extra treatment. It could also spare patients at low risk of disease recurrence from unnecessary treatment and its side effects.

Authors

Carmen Rubio-Alarcón, Andrew Georgiadis, Ingrid A. Franken, Haoyue Wang, Sietske C. M. W. van Nassau, Suzanna J. Schraa, Dave E. W. van der Kruijssen, Karlijn van Rooijen, Theodora C. Linders, Pien Delis-van Diemen, Maartje Alkemade, Anne Bolijn, Marianne Tijssen, Margriet Lemmens, Lana Meiqari, Steven L. C. Ketelaars, Adria Closa-Mosquera, Miranda M. W. van Dongen, Mirthe Lanfermeijer, Birgit I. Lissenberg-Witte, Linda J. W. Bosch, Teunise Bisschop-Snetselaar, Bregje C. Adriaans, Amy Greer, David Riley, James R. White, Christopher Greco, Liam Cox, Jesse Fox, Kaitlin Victor, Catherine Leech, Samuel V. Angiuoli, Niels F. M. Kok, Cornelis J. A. Punt, Daan van den Broek, Miriam Koopman, Gerrit A. Meijer, Victor E. Velculescu, Jeanine M. L. Roodhart, Veerle M. H. Coupé, Mark Sausen, Geraldine R. Vink, Remond J. A. Fijneman,  and Other Members of the PLCRC-MEDOCC Group