Medicine and Health

Baseline ctDNA gene alterations as a biomarker of survival after panitumumab and chemotherapy in metastatic colorectal cancer

K. Shitara, K. Muro, et al.

This groundbreaking study by Kohei Shitara and colleagues reveals how circulating tumor DNA (ctDNA) gene alterations can influence the treatment efficacy in patients with metastatic colorectal cancer. The research highlights the potential of ctDNA to guide treatment decisions, showing improved survival rates with specific therapies based on gene alteration status.

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Abstract

This study investigated the association between circulating tumor DNA (ctDNA) gene alterations and efficacy outcomes in the PARADIGM trial (n=733) of patients with RAS wild-type metastatic colorectal cancer (mCRC). Overall survival was prolonged with panitumumab plus modified FOLFOX6 versus bevacizumab plus modified FOLFOX6 in patients with ctDNA lacking gene alterations (median 40.7 vs 34.4 months; hazard ratio, 0.76). However, survival was similar or inferior with panitumumab in patients with ctDNA containing any alteration (19.2 vs 22.2 months; hazard ratio, 1.13). Negative hyperselection using ctDNA may guide treatment selection in mCRC.

Publisher

Nature Medicine

Published On

Mar 01, 2024

Authors

Kohei Shitara, Kei Muro, Jun Watanabe, Kentaro Yamazaki, Hisatsugu Ohori, Manabu Shiozawa, Atsuo Takashima, Mitsuru Yokota, Akitaka Makiyama, Naoya Akazawa, Hitoshi Ojima, Yasuhiro Yuasa, Keisuke Miwa, Hirofumi Yasui, Eiji Oki, Takeo Sato, Takeshi Naitoh, Yoshito Komatsu, Takeshi Kato, Ikuo Mori, Kazunori Yamanaka, Masamitsu Hihara, Junpei Soeda, Toshihiro Misumi, Kouji Yamamoto, Riu Yamashita, Kiwamu Akagi, Atsushi Ochiai, Hiroyuki Uetake, Katsuya Tsuchihara, Takayuki Yoshino

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