ASO Author Reflections: Perioperative Genomic Profiles and Prognosis of Peripheral and Perihepatic Circulating Tumor DNA in Patients with Colorectal Liver Metastases

Excerpt

Resection of colorectal cancer liver metastases (CRLM) is offered to an increasing number of patients. Despite advancements in hepatic imaging and mutation knowledge, prediction of aggressive tumor biology likely to resist therapy or recur soon after resection remains challenging. Novel liquid biopsy markers, such as circulating tumor DNA (ctDNA), have gained interest for their ability to predict survival.1 This serologic test can also detect tumor mutations predictive of resistance to therapeutic agents, such as cetuximab,2 and early recurrence after resection.3 Published reports on ctDNA have investigated peripherally-obtained samples, however circulating tumor cells from the perihepatic circulation may be more prognostic than those found peripherally.4 Our study compares the agreement and prognostic utility of mutations detected in ctDNA obtained prior to resection from an intraoperatively accessed peripheral vein (PERIPH), portal and hepatic veins (PV and HV, respectively), and the resected tumor.5 …