Background/Objectives: Nonoperative management (NOM) of patients with locally advanced rectal cancer (LARC) who achieve a complete clinical response (cCR) to total neoadjuvant therapy (TNT) has been shown to be oncologically safe and is an attractive treatment option for patients. However, identifying responders to TNT that may benefit from nonoperative management is clinically challenging. Circulating tumor DNA (ctDNA) testing has shown promise in detecting minimal residual disease but has not yet been studied extensively within this clinical context.Methods: This is a single-institution retrospective case series study of LARC patients treated with TNT from 2019 to 2023 who underwent ctDNA testing as an adjunct to standard clinical response assessments.Results: A total of 28 patients had ctDNA testing as part of their response assessments after TNT. In total, 9 patients had positive ctDNA, and 19 patients had negative ctDNA during surveillance. Baseline characteristics of these two groups were not different. In this study, 6/9 (67%) patients who had positive ctDNA required surgery for residual rectal cancer, whereas only 4/19 (21%) patients who had negative ctDNA required surgery (p= 0.035).Conclusions: ctDNA testing has the potential to detect MRD in LARC patients treated with TNT.
背景/目的：对于局部晚期直肠癌患者，在接受全程新辅助治疗后达到完全临床缓解的患者采用非手术治疗策略已被证明在肿瘤学上是安全的，并且对患者而言是一种有吸引力的治疗选择。然而，在临床上识别可能从非手术治疗中获益的对TNT有反应者具有挑战性。循环肿瘤DNA检测在检测微小残留病灶方面显示出潜力，但在此临床背景下尚未得到广泛研究。 方法：本研究是一项单机构回顾性病例系列研究，纳入了2019年至2023年间接受TNT治疗的LARC患者，这些患者在标准临床反应评估之外还接受了ctDNA检测。 结果：共有28名患者在TNT后的反应评估中接受了ctDNA检测。总体而言，在监测期间，9名患者ctDNA检测呈阳性，19名患者呈阴性。这两组患者的基线特征没有差异。在本研究中，9名ctDNA阳性患者中有6名（67%）因残留直肠癌需要接受手术，而19名ctDNA阴性患者中仅有4名（21%）需要手术（p=0.035）。 结论：ctDNA检测有潜力检测出接受TNT治疗的LARC患者的微小残留病灶。
肿瘤(癌症)患者之家