Circulating tumor DNA can be used to define minimal residual disease after resection of liver metastases. Despite surgical resection, the rates of recurrence (and post-operative minimal residual disease) are higher in this setting (stage IV) than in early stages of the disease. Here from expert Tim Newhook, a hepatobiliary surgeon with expertise in colorectal liver metastases and ctDNA, on the the potential for ctDNA to provide prognostic information and potentially guide therapy. Additionally, learn how ctDNA may be used to enroll into novel clinical trials.
Table of contents
00:00: Introduction
00:45: Dr. Newhook tells us about his path to being a liver surgeon
06:00: What are biomarkers?
07:45: Hepatectomy for CRC liver mets — biomarkers needed
10:16: Adj and peri-op chemo therapy for resectable CRC liver mets
12:15: Rationale for preoperative therapy — what is occult disease?
14:40: Tumor mutational profiling
16:18: Role of RAS mutations, & other mutations?
18:20: What is ctDNA? Types of tests?
22:30: What is minimal residual disease?
25:20: CIRCULATE-Japan results
27:00: CtDNA and liver resection, pros & cons
31:40: CtDNA and liver resection: published studies
42:30: Who is at higher risk of MRD after liver resection?
44:22: Predictors of post-op ctDNA detection
46:10: Can ctDNA guide treatment decisions?
47:49: Multi-D management of resectable CRC liver mets
50:00: NCT05062317-Details
56:00: Conclusions
57:30: Q & A
Please see the Lecture Hall in ColonTown for more great content on colorectal cancer! Many thanks to the ColonTown team and Manju George for the great content.
