Abstract
High rates of detection of metastatic/recurrent colorectal cancer on clinical imaging at the time of molecular residual disease testing following operative management
Journal of clinical oncology, Vol.41(16_suppl), pp.e15543-e15543
06/01/2023
DOI: 10.1200/JCO.2023.41.16_suppl.e15543
Abstract
e15543
Background: Detection of circulating tumor DNA (ctDNA) following operative management for colorectal cancer (CRC) as part of molecular residual disease (MRD) assays has shown significant prognostic implications. The majority of studies examining the time to detection of cancer recurrence have been done retrospectively without the treating physician knowing the results of the assay. Limited prospective data exists regarding the probability of detecting cancer on imaging at the time of a positive MRD test following operative management of all sites of disease. Here, we analyze the association of positive MRD testing with imaging findings of recurrent or metastatic CRC using a cohort of patients that underwent prospective MRD testing. Methods: Patients with stage I-IV intestinal cancers at University of Wisconsin Carbone Cancer Center who underwent prospective Natera Signatera MRD testing following operative management of their disease were identified and consented to an IRB-approved registry protocol. Those consented patients who had a positive test without being on systemic therapy and had clinical imaging within 45 days were analyzed further. The presence of definitive cancer, indeterminate findings, and no evidence of cancer was recorded per the treating physician using standard of care clinical imaging. The presence of cancer on imaging was then correlated with the quantity of ctDNA (mean tumor molecules (MTM)/ml). Results: 163 patients with stage I-IV CRC and 1 small intestinal cancer underwent MRD testing. 30 positive ctDNA tests with imaging were available across 22 unique patients (median age 54 years (29-84) 7 females). 23 samples were in the resected metastatic setting, 5 stage III and 2 stage I. Cancer was seen on imaging in 19/30 (63%) of positive tests, indeterminate in 3 (10%) and negative for cancer in 9/30 (27%). With ctDNA levels > 10 MTM/ml (n = 7), cancer was detected on imaging in all cases. With ctDNA levels of 1-10 MTM/ml cancer was detected in 42% and at < 1 MTM/ml in 64%. A trend towards greater detection of cancer was observed when MRI or PET/CT was performed. Radiologic disease detection in patients with positive MRD analysis was higher in those with stage IV disease (70%) vs. stage I-III (43%). Conclusions: ctDNA MRD positivity is associated with high rates of detection of recurrent/metastatic CRC, especially in patients with resected stage IV disease and with a quantity of > 10 MTM/ml. Clinical imaging should be considered at the time of detection of ctDNA.
Details
- Title: Subtitle
- High rates of detection of metastatic/recurrent colorectal cancer on clinical imaging at the time of molecular residual disease testing following operative management
- Creators
- Danny Trotier - University of Wisconsin Carbone Cancer CenterKayla Lemmon - University of Wisconsin Carbone Cancer CenterDanielle Golner - University of Wisconsin Carbone Cancer CenterMaddie Buratti - University of Wisconsin Carbone Cancer CenterAlyssa DeZeeuw - University of Wisconsin Carbone Cancer CenterNoelle K. LoConte - University of Wisconsin Carbone Cancer CenterSam Joseph Lubner - University of Wisconsin Carbone Cancer CenterNataliya Volodymyrivna Uboha - University of Wisconsin Carbone Cancer CenterJeremy D. Kratz - University of Wisconsin Carbone Cancer CenterMonica Arun Patel - University of Wisconsin Carbone Cancer CenterEvie Carchman - University of Wisconsin Carbone Cancer CenterKristina A. Matkowskyj - University of Wisconsin Carbone Cancer CenterWei Zhang - University of Wisconsin Carbone Cancer CenterMark E. Burkard - University of Wisconsin Carbone Cancer CenterDustin A. Deming - University of Wisconsin Carbone Cancer Center
- Resource Type
- Abstract
- Publication Details
- Journal of clinical oncology, Vol.41(16_suppl), pp.e15543-e15543
- DOI
- 10.1200/JCO.2023.41.16_suppl.e15543
- ISSN
- 0732-183X
- eISSN
- 1527-7755
- Language
- English
- Date published
- 06/01/2023
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984700643802771
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