Dr. Boland on Efforts Underway to Optimize the Utility of ctDNA in CRC

Patrick Boland, MD, medical oncologist, member of the gastrointestinal oncology team, active member of the NCI National Clinical Trial Network, discusses the utility of circulating tumor DNA (ctDNA) in patients with metastatic colorectal cancer (CRC).

The emergence of ctDNA represents the future in metastatic CRC, according to Boland, who adds that this has been utilized in the gastrointestinal space and in other cancers. Multiple studies show that the presence of ctDNA after surgery is a poor prognosticator, and its absence is a good prognosticator, Boland says. 

Randomized studies are needed to demonstrate how to best utilize ctDNA and whether patients who are negative could omit chemotherapy, given there is not a proven survival benefit with post-operative chemotherapy, Boland adds. Moreover, there may be potential to escalate therapy for those with ctDNA positivity to improve long-term outcomes, Boland adds. The hope is that ongoing studies will address remaining questions, Boland concludes.