Clinical utility of circulating tumor DNA for colorectal cancer

Summary

Colorectal cancer (CRC) is currently the most common types of cancer in Japan, and its prognosis has been improved because of development of diagnosis and advancement in treatments including surgery and chemotherapy. However, because of intra‐tumor heterogeneity, and clonal evolution, tumors often develop resistance to treatments. Genotyping tumor tissue in search of somatic genetic alterations for actionable information has become routine examination in the clinical practice. However, the inherent molecular heterogeneity of metastatic tumors and the ability of cancer genomes to dynamically evolve are not properly captured by only tissue specimens. Circulating tumor DNA (ctDNA) carrying tumor specific genetic or epigenetic alterations is released into the circulation from tumor cells undergoing apoptosis, or necrosis. Analysis of ctDNA has the potential to change of the clinical practice by exploiting blood rather than tissue, as a source of information. Here, we provide an overview of the characteristics of ctDNA, and focus on detection methods for ctDNA, and the feasibility of use of ctDNA to monitor tumor dynamics for patients with colorectal cancer.

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