TY - JOUR
T1 - Blood, Toil, and Taxoteres
T2 - Biological Determinates of Treatment-Induce ctDNA Dynamics for Interpreting Tumor Response
AU - Boniface, Christopher T.
AU - Spellman, Paul T.
N1 - Publisher Copyright:
Copyright © 2022 Boniface and Spellman.
PY - 2022/5/19
Y1 - 2022/5/19
N2 - Collection and analysis of circulating tumor DNA (ctDNA) is one of the few methods of liquid biopsy that measures generalizable and tumor specific molecules, and is one of the most promising approaches in assessing the effectiveness of cancer care. Clinical assays that utilize ctDNA are commercially available for the identification of actionable mutations prior to treatment and to assess minimal residual disease after treatment. There is currently no clinical ctDNA assay specifically intended to monitor disease response during treatment, partially due to the complex challenge of understanding the biological sources of ctDNA and the underlying principles that govern its release. Although studies have shown pre- and post-treatment ctDNA levels can be prognostic, there is evidence that early, on-treatment changes in ctDNA levels are more accurate in predicting response. Yet, these results also vary widely among cohorts, cancer type, and treatment, likely due to the driving biology of tumor cell proliferation, cell death, and ctDNA clearance kinetics. To realize the full potential of ctDNA monitoring in cancer care, we may need to reorient our thinking toward the fundamental biological underpinnings of ctDNA release and dissemination from merely seeking convenient clinical correlates.
AB - Collection and analysis of circulating tumor DNA (ctDNA) is one of the few methods of liquid biopsy that measures generalizable and tumor specific molecules, and is one of the most promising approaches in assessing the effectiveness of cancer care. Clinical assays that utilize ctDNA are commercially available for the identification of actionable mutations prior to treatment and to assess minimal residual disease after treatment. There is currently no clinical ctDNA assay specifically intended to monitor disease response during treatment, partially due to the complex challenge of understanding the biological sources of ctDNA and the underlying principles that govern its release. Although studies have shown pre- and post-treatment ctDNA levels can be prognostic, there is evidence that early, on-treatment changes in ctDNA levels are more accurate in predicting response. Yet, these results also vary widely among cohorts, cancer type, and treatment, likely due to the driving biology of tumor cell proliferation, cell death, and ctDNA clearance kinetics. To realize the full potential of ctDNA monitoring in cancer care, we may need to reorient our thinking toward the fundamental biological underpinnings of ctDNA release and dissemination from merely seeking convenient clinical correlates.
KW - biomarkers
KW - circulating tumor DNA
KW - ctDNA
KW - liquid biopsy
KW - treatment response
KW - tumor growth
UR - http://www.scopus.com/inward/record.url?scp=85131344565&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85131344565&partnerID=8YFLogxK
U2 - 10.3389/pore.2022.1610103
DO - 10.3389/pore.2022.1610103
M3 - Review article
C2 - 35665409
AN - SCOPUS:85131344565
SN - 1219-4956
VL - 28
JO - Pathology and Oncology Research
JF - Pathology and Oncology Research
M1 - 1610103
ER -