ESMO recommendations on the use of circulating tumour DNA assays for patients with cancer: a report from the ESMO Precision Medicine Working Group.
Por:
Pascual J, Attard G, Bidard FC, Curigliano G, De Mattos-Arruda L, Diehn M, Italiano A, Lindberg J, Merker JD, Montagut C, Normanno N, Pantel K, Pentheroudakis G, Popat S, Reis-Filho JS, Tie J, Seoane J, Tarazona N, Yoshino T, Turner NC
Publicada:
1 ago 2022
Ahead of Print:
6 jul 2022
Resumen:
Circulating tumour DNA (ctDNA) assays conducted on plasma are rapidly developing a strong evidence base for use in patients with cancer. The European Society for Medical Oncology convened an expert working group to review the analytical and clinical validity and utility of ctDNA assays. For patients with advanced cancer, validated and adequately sensitive ctDNA assays have utility in identifying actionable mutations to direct targeted therapy, and may be used in routine clinical practice, provided the limitations of the assays are taken into account. Tissue-based testing remains the preferred test for many cancer patients, due to limitations of ctDNA assays detecting fusion events and copy number changes, although ctDNA assays may be routinely used when faster results will be clinically important, or when tissue biopsies are not possible or inappropriate. Reflex tumour testing should be considered following a non-informative ctDNA result, due to false-negative results with ctDNA testing. In patients treated for early-stage cancers, detection of molecular residual disease or molecular relapse, has high evidence of clinical validity in anticipating future relapse in many cancers. Molecular residual disease/molecular relapse detection cannot be recommended in routine clinical practice, as currently there is no evidence for clinical utility in directing treatment. Additional potential applications of ctDNA assays, under research development and not recommended for routine practice, include identifying patients not responding to therapy with early dynamic changes in ctDNA levels, monitoring therapy for the development of resistance mutations before clinical progression, and in screening asymptomatic people for cancer. Recommendations for reporting of results, future development of ctDNA assays and future clinical research are made.
Filiaciones:
Pascual J:
Medical Oncology Intercenter Unit, Regional and Virgen de la Victoria University Hospitals, IBIMA, Malaga, Spain
Attard G:
Urological Cancer Research, University College London, London, UK
Bidard FC:
Department of Medical Oncology, Institut Curie, Paris, France
University of Versailles Saint-Quentin-en-Yvelines (UVSQ)/Paris-Saclay University, Saint Cloud, France
Curigliano G:
Department of Oncology and Hemato-Oncology, University of Milano, Milan, Italy
Division of Early Drug Development, European Institute of Oncology, IRCCS, Milan, Italy
De Mattos-Arruda L:
IrsiCaixa, Hospital Universitari Trias i Pujol, Badalona, Spain
Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain
Diehn M:
Department of Radiation Oncology, Stanford University School of Medicine, Stanford, USA
Italiano A:
Early Phase Trials and Sarcoma Units, Institut Bergonie, Bordeaux, France
DITEP, Gustave Roussy, Villejuif, France
Faculty of Medicine, University of Bordeaux, Bordeaux, France
Lindberg J:
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden
Merker JD:
Departments of Pathology and Laboratory Medicine & Genetics, UNC School of Medicine, Chapel Hill, USA
Montagut C:
Medical Oncology Department, Hospital del Mar-IMIM, CIBERONC, Universitat Pompeu Fabra, Barcelona, Spain
Normanno N:
Cell Biology and Biotherapy Unit, Istituto Nazionale Tumori, 'Fondazione G. Pascale' - IRCCS, Naples, Italy
Pantel K:
Institute for Tumour Biology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
Pentheroudakis G:
Scientific and Medical Division, European Society for Medical Oncology, Lugano, Switzerland
Popat S:
Royal Marsden Hospital, London, UK
Institute of Cancer Research, London, UK
Reis-Filho JS:
Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, USA
Tie J:
Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
Division of Personalised Oncology, Walter and Eliza Hall Institute of Medical Research, Melbourne, Australia
Seoane J:
Preclinical and Translational Research Programme, Vall d'Hebron Institute of Oncology (VHIO), ICREA, CIBERONC, Barcelona, Spain
Medical School, Universitat Autònoma de Barcelona, Barcelona, Spain
Tarazona N:
Department of Medical Oncology, INCLIVA Biomedical Research Institute, University of Valencia, Valencia, Spain
Instituto de Salud Carlos III, CIBERONC, Madrid, Spain
Yoshino T:
Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Chiba, Japan
Turner NC:
Royal Marsden Hospital, London, UK
Institute of Cancer Research, London, UK
hybrid, Green Published
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