DENEB: Development of new criteria for curability after local excision of pathological T1 colorectal cancer using liquid biopsy

Cancer Sci. 2022 Apr;113(4):1531-1534. doi: 10.1111/cas.15226. Epub 2022 Feb 28.

Abstract

According to the current international guidelines, high-risk patients diagnosed with pathological T1 (pT1) colorectal cancer (CRC) who underwent complete local resection but may have risk of developing lymph node metastasis (LNM) are recommended additional intestinal resection with lymph node dissection. However, around 90% of the patients without LNM are exposed to the risk of being overtreated due to the insufficient pathological criteria for risk stratification of LNM. Circulating tumor DNA (ctDNA) is a noninvasive biomarker for molecular residual disease and relapse detection after treatments including surgical and endoscopic resection of solid tumors. The CIRCULATE-Japan project includes a large-scale patient-screening registry of the GALAXY study to track ctDNA status of patients with stage II to IV or recurrent CRC that can be completely resected. Based on the CIRCULATE-Japan platform, we launched DENEB, a new prospective study, within the GALAXY study for patients with pT1 CRC who underwent complete local resection and were scheduled for additional intestinal resection with lymph node dissection based on the standard pathologic risk stratification criteria for LNM. The aim of this study is to explore the ability of predicting LNM using ctDNA analysis compared with the standard pathological criteria. The ctDNA assay will build new evidence to establish a noninvasive personalized diagnosis in patients, which will facilitate tailored/optimal treatment strategies for CRC patients.

Keywords: circulating tumor DNA; colorectal cancer; local resection; lymph node metastasis; pathological T1.

MeSH terms

  • Circulating Tumor DNA* / genetics
  • Colorectal Neoplasms* / genetics
  • Colorectal Neoplasms* / pathology
  • Colorectal Neoplasms* / surgery
  • Humans
  • Liquid Biopsy
  • Lymph Node Excision
  • Lymph Nodes / pathology
  • Lymphatic Metastasis / pathology
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Staging
  • Prospective Studies
  • Retrospective Studies
  • Risk Factors

Substances

  • Circulating Tumor DNA