Early Detection of Circulating Tumor DNA Postoperatively Enables Discovery of Resectable Metastatic Disease in a Patient with Colon Cancer
Abstract Currently, serum carcinoembryonic agent (CEA) along with contrast-enhanced imaging and colonoscopy are used for evaluation of recurrence of colorectal cancer. However, CEA is an unreliable and nonspecific biomarker that may fail to rise and signal relapse. Analysis of circulating tumor DNA...
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| Veröffentlicht in: | Case Reports in Oncology 2021-12, Vol.14 (3), p.1748-1753 |
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| container_title | Case Reports in Oncology |
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| creator | Weinberg, Benjamin A. Winslow, Emily R. Bayasi, Mohammed Krainock, Michael R. Olshan, Perry M. Billings, Paul R. Aleshin, Alexey |
| description | Abstract
Currently, serum carcinoembryonic agent (CEA) along with contrast-enhanced imaging and colonoscopy are used for evaluation of recurrence of colorectal cancer. However, CEA is an unreliable and nonspecific biomarker that may fail to rise and signal relapse. Analysis of circulating tumor DNA (ctDNA) in patients offers a minimally invasive method to assess risk of relapse several months ahead of conventional clinical means. Here, we report the case of a colon adenocarcinoma with postoperative liver metastasis diagnosed early by ctDNA measurement, using a personalized NGS-mPCR assay. While ctDNA levels continued to rise, CEA levels tested negative. Metastatic relapse to the liver was promptly confirmed by PET/CT scan. The patient underwent a successful metastasectomy with curative intent. Following surgery, the patient exhibited no evidence of disease and ctDNA levels remained negative. Our case report suggests that the early detection of postoperative molecular residual disease by means of ctDNA measurement can accurately predict mCRC relapse in cases where CEA levels fail to increase. Close monitoring of ctDNA levels during the postoperative period can allow for earlier intervention and more favorable outcomes in relapsing mCRC patients. |
| doi_str_mv | 10.1159/000520743 |
| format | Article |
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Currently, serum carcinoembryonic agent (CEA) along with contrast-enhanced imaging and colonoscopy are used for evaluation of recurrence of colorectal cancer. However, CEA is an unreliable and nonspecific biomarker that may fail to rise and signal relapse. Analysis of circulating tumor DNA (ctDNA) in patients offers a minimally invasive method to assess risk of relapse several months ahead of conventional clinical means. Here, we report the case of a colon adenocarcinoma with postoperative liver metastasis diagnosed early by ctDNA measurement, using a personalized NGS-mPCR assay. While ctDNA levels continued to rise, CEA levels tested negative. Metastatic relapse to the liver was promptly confirmed by PET/CT scan. The patient underwent a successful metastasectomy with curative intent. Following surgery, the patient exhibited no evidence of disease and ctDNA levels remained negative. Our case report suggests that the early detection of postoperative molecular residual disease by means of ctDNA measurement can accurately predict mCRC relapse in cases where CEA levels fail to increase. Close monitoring of ctDNA levels during the postoperative period can allow for earlier intervention and more favorable outcomes in relapsing mCRC patients.</description><identifier>ISSN: 1662-6575</identifier><identifier>EISSN: 1662-6575</identifier><identifier>DOI: 10.1159/000520743</identifier><identifier>PMID: 35082635</identifier><language>eng</language><publisher>Basel, Switzerland: S. Karger AG</publisher><subject>Abdomen ; Biomarkers ; Cancer cells ; Cancer therapies ; carcinoembryonic agent ; Care and treatment ; Case Report ; Case reports ; Case studies ; circulating tumor dna ; Colon cancer ; Colorectal cancer ; Complications and side effects ; Diagnosis ; DNA ; DNA methylation ; Genetic aspects ; Health aspects ; Identification and classification ; Intestinal obstruction ; liver metastasis ; Medical imaging ; Metastasis ; metastatic colorectal cancer ; Methods ; Mutation ; Patients ; Postoperative care ; Prognosis ; Surgery ; Surveillance</subject><ispartof>Case Reports in Oncology, 2021-12, Vol.14 (3), p.1748-1753</ispartof><rights>2021 The Author(s). Published by S. Karger AG, Basel</rights><rights>Copyright © 2021 by The Author(s). Published by S. Karger AG, Basel.</rights><rights>COPYRIGHT 2021 S. Karger AG</rights><rights>2021 The Author(s). Published by S. Karger AG, Basel . Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the associated terms available at: https://uk.sagepub.com/en-gb/eur/reusing-open-access-and-sage-choice-content</rights><rights>Copyright © 2021 by The Author(s). Published by S. Karger AG, Basel 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c552t-681b81139ab5b8fb29f120900058ea100a74071cccb2ead9f214f10581a230a3</citedby><orcidid>0000-0003-1198-0537 ; 0000-0002-0408-4817</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8739946/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8739946/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2095,27614,27903,27904,53770,53772</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35082635$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Weinberg, Benjamin A.</creatorcontrib><creatorcontrib>Winslow, Emily R.</creatorcontrib><creatorcontrib>Bayasi, Mohammed</creatorcontrib><creatorcontrib>Krainock, Michael R.</creatorcontrib><creatorcontrib>Olshan, Perry M.</creatorcontrib><creatorcontrib>Billings, Paul R.</creatorcontrib><creatorcontrib>Aleshin, Alexey</creatorcontrib><title>Early Detection of Circulating Tumor DNA Postoperatively Enables Discovery of Resectable Metastatic Disease in a Patient with Colon Cancer</title><title>Case Reports in Oncology</title><addtitle>Case Rep Oncol</addtitle><description>Abstract
Currently, serum carcinoembryonic agent (CEA) along with contrast-enhanced imaging and colonoscopy are used for evaluation of recurrence of colorectal cancer. However, CEA is an unreliable and nonspecific biomarker that may fail to rise and signal relapse. Analysis of circulating tumor DNA (ctDNA) in patients offers a minimally invasive method to assess risk of relapse several months ahead of conventional clinical means. Here, we report the case of a colon adenocarcinoma with postoperative liver metastasis diagnosed early by ctDNA measurement, using a personalized NGS-mPCR assay. While ctDNA levels continued to rise, CEA levels tested negative. Metastatic relapse to the liver was promptly confirmed by PET/CT scan. The patient underwent a successful metastasectomy with curative intent. Following surgery, the patient exhibited no evidence of disease and ctDNA levels remained negative. Our case report suggests that the early detection of postoperative molecular residual disease by means of ctDNA measurement can accurately predict mCRC relapse in cases where CEA levels fail to increase. Close monitoring of ctDNA levels during the postoperative period can allow for earlier intervention and more favorable outcomes in relapsing mCRC patients.</description><subject>Abdomen</subject><subject>Biomarkers</subject><subject>Cancer cells</subject><subject>Cancer therapies</subject><subject>carcinoembryonic agent</subject><subject>Care and treatment</subject><subject>Case Report</subject><subject>Case reports</subject><subject>Case studies</subject><subject>circulating tumor dna</subject><subject>Colon cancer</subject><subject>Colorectal cancer</subject><subject>Complications and side effects</subject><subject>Diagnosis</subject><subject>DNA</subject><subject>DNA methylation</subject><subject>Genetic aspects</subject><subject>Health aspects</subject><subject>Identification and classification</subject><subject>Intestinal obstruction</subject><subject>liver metastasis</subject><subject>Medical imaging</subject><subject>Metastasis</subject><subject>metastatic colorectal cancer</subject><subject>Methods</subject><subject>Mutation</subject><subject>Patients</subject><subject>Postoperative care</subject><subject>Prognosis</subject><subject>Surgery</subject><subject>Surveillance</subject><issn>1662-6575</issn><issn>1662-6575</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>M--</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DOA</sourceid><recordid>eNptklFv0zAQgCMEYmPwwDtClnjiocN24sR5QarSApMGm6a-W2fn3LmkcbHTov4FfjUOLWWTUB4c3X33-c66LHvN6CVjov5AKRWcVkX-JDtnZcknpajE0wf_Z9mLGFeUlrUoxfPsLBdU8jIX59mvOYRuT2Y4oBmc74m3pHHBbDsYXL8ki-3aBzL7NiW3Pg5-gyHFd5hK5j3oDiOZuWj8DsN-LL3DmDxjgnzFAeKQaDMiCBGJ6wmQ2xTCfiA_3XBPGt-lOxvoDYaX2TMLXcRXx_MiW3yaL5ovk-ubz1fN9HpihODDpJRMS8byGrTQ0mpeW8ZpPb6BRGCUQlXQihljNEdoa8tZYVlKMuA5hfwiuzpoWw8rtQluDWGvPDj1J-DDUkFIXXeoksC0Nr0fL4qCCtDGMlkxbbSRWlOeXB8Prs1Wr7E1aa4A3SPp40zv7tXS75Ss8rouyiR4dxQE_2OLcVArvw19Gl_xkpW1FAWVibo8UEtIXbne-iQz6Wtx7Yzv0boUn5ZSVlXF67Hg_aHABB9jQHtqiVE1row6rUxi3z6c4UT-3ZF_PX6HsMRwApq7m4NCbVqbqDf_pY63_AbUydGr</recordid><startdate>20211210</startdate><enddate>20211210</enddate><creator>Weinberg, Benjamin A.</creator><creator>Winslow, Emily R.</creator><creator>Bayasi, Mohammed</creator><creator>Krainock, Michael R.</creator><creator>Olshan, Perry M.</creator><creator>Billings, Paul R.</creator><creator>Aleshin, Alexey</creator><general>S. 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Currently, serum carcinoembryonic agent (CEA) along with contrast-enhanced imaging and colonoscopy are used for evaluation of recurrence of colorectal cancer. However, CEA is an unreliable and nonspecific biomarker that may fail to rise and signal relapse. Analysis of circulating tumor DNA (ctDNA) in patients offers a minimally invasive method to assess risk of relapse several months ahead of conventional clinical means. Here, we report the case of a colon adenocarcinoma with postoperative liver metastasis diagnosed early by ctDNA measurement, using a personalized NGS-mPCR assay. While ctDNA levels continued to rise, CEA levels tested negative. Metastatic relapse to the liver was promptly confirmed by PET/CT scan. The patient underwent a successful metastasectomy with curative intent. Following surgery, the patient exhibited no evidence of disease and ctDNA levels remained negative. Our case report suggests that the early detection of postoperative molecular residual disease by means of ctDNA measurement can accurately predict mCRC relapse in cases where CEA levels fail to increase. Close monitoring of ctDNA levels during the postoperative period can allow for earlier intervention and more favorable outcomes in relapsing mCRC patients.</abstract><cop>Basel, Switzerland</cop><pub>S. Karger AG</pub><pmid>35082635</pmid><doi>10.1159/000520743</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0003-1198-0537</orcidid><orcidid>https://orcid.org/0000-0002-0408-4817</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Abdomen Biomarkers Cancer cells Cancer therapies carcinoembryonic agent Care and treatment Case Report Case reports Case studies circulating tumor dna Colon cancer Colorectal cancer Complications and side effects Diagnosis DNA DNA methylation Genetic aspects Health aspects Identification and classification Intestinal obstruction liver metastasis Medical imaging Metastasis metastatic colorectal cancer Methods Mutation Patients Postoperative care Prognosis Surgery Surveillance |
| title | Early Detection of Circulating Tumor DNA Postoperatively Enables Discovery of Resectable Metastatic Disease in a Patient with Colon Cancer |
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