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Chromosomal alterations and liquid biopsies as monitoring and prognostic biomarkers in metastatic colorectal cancer

Subject Area General and Visceral Surgery
Term from 2022 to 2024
Project identifier Deutsche Forschungsgemeinschaft (DFG) - Project number 513004649
 
Final Report Year 2025

Final Report Abstract

Metastases are the leading cause of mortality in colorectal cancer patients. In recent years, the analysis of circulating tumor DNA (ctDNA) from blood samples has emerged as a promising tool for personalised treatment options and treatment monitoring in those patients. This project utilized two independent datasets to investigate, on the one hand, the biological and clinical determinants of ctDNA levels and, on the other, how ctDNA dynamics compare to radiological tumor volume as predictive markers for treatment response and prognosis. In the first part of the study, we analyzed data from 150 patients with non-metastatic colon cancer from the PLCRC cohort. Our findings revealed that ctDNA levels are influenced by tumor size, chromosomal instability, and specific gene expression patterns. Notably, certain genomic alterations, such as loss of chromosome 10p or 10q, were associated with increased ctDNA levels. The second part of the study used an independent dataset from the CAIRO5 trial, which included patients with metastatic CRC. Here, we compared ctDNA measurements with radiological tumor volume (TTV) assessments. The results demonstrated that both ctDNA and TTV independently correlate with prognosis. While radiological imaging offers a macroscopic view of tumor burden, ctDNA dynamics can provide an early indication of treatment response and an additional molecular perspective. Combining both modalities improved the predictive accuracy for overall survival and early recurrence risk. These findings highlight the potential of liquid biopsies as a valuable addition to imaging in clinical practice. Integrating both approaches could enhance disease monitoring and enable more personalized treatment strategies.

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