ctDNA promising biomarker for recurrence of pancreatic cancer

In patients with pancreatic duct adenocarcinoma (PDAC), ctDNA positivity after surgery was associated with decreased recurrence-free survival (RFS) rates. In contrast, the standard-of-care biomarker CA19-9 did not display this association. Furthermore, ctDNA may be able to predict recurrence long before it can be detected on radiographic imaging. This may allow clinicians to switch therapies in time and offer better health outcomes for their patients with PDAC [1].

“Carbohydrate antigen (CA19-9) is widely used as a biomarker in patients with pancreatic cancer,” said Dr Gregory Botta (UCSD Moores Cancer Center, CA, USA). “However, CA19-9 lacks sensitivity and specificity. Since ctDNA has shown to be a promising biomarker in other types of cancer, the current study aimed to investigate whether ctDNA is predictive of recurrence in patients with PDAC. With early detection of recurrence, interventions can be initiated swiftly.” In total, 116 patients with PDAC (stage I to III) were followed up for a median of 13.6 months to assess ctDNA levels with a personalised, tumour-informed ctDNA assay.

After adjusting for clinical risk factors, ctDNA detection after surgery (any time) was a strong predictor for RFS (HR 5.64; 95% CI 2.4–12.88; P<0.001). In addition, a longitudinal analysis showed that ctDNA was significantly prognostic for RFS (HR 8.2; 95% 3.4–19.9; P<0.001), whereas CA19-9 was not (HR 2.4; P=0.17). Dr Botta added that case analyses showed that ctDNA can predict recurrence of PDAC with significant lead time, providing an opportunity to change treatment regimens before recurrence can be detected on radiographic imaging.

1. Botta GP, et al. Association of personalized and tumor-informed ctDNA with patient survival outcomes in pancreatic adenocarcinoma. Abstract 517, ASCO GI 2022, 20–22 January.

 

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Posted on 21 March, 202221 March, 2022