Post-operative ctDNA monitoring in stage I colon cancer: A case report

Stephanie L. Alden, Harmeet Dhani, Charuta C. Palsuledesai, Shifra Krinshpun, Adham Jurdi, Eric Christenson, Ilene Browner, Samuel Rosner

Research output: Contribution to journalArticlepeer-review

Abstract

Circulating tumor DNA (ctDNA) level monitoring after surgery for colon cancer has been studied in stage II and III colon cancer to risk-stratify patients for adjuvant therapy. However, there is less data regarding the role of this diagnostic tool in the management of stage I disease, where current recommended surveillance is limited to screening colonoscopy at one year. In this report, we describe the case of a 57-year-old man with stage I colon cancer who underwent complete resection with adequate lymph node surgical sampling, normal preoperative CEA and no evidence of metastatic disease on initial imaging. The patient elected to undergo serial ctDNA monitoring after surgery. Rising ctDNA levels, five months after resection, prompted cross-sectional imaging which demonstrated metastatic disease to the liver. The patient subsequently received five cycles of leucovorin, 5-fluorouracil, oxaliplatin, and irinotecan with bevacizumab (FOLFOXIRI-Bev) and definitive microwave ablation to the liver metastases, with resulting undetectable ctDNA levels. The patient’s imaging and colonoscopy one-year post-operatively showed no evidence of disease, with ctDNA levels remaining undetectable. This report highlights the value of ctDNA monitoring in patients with early-stage colon cancer and suggests that further, large-scale studies may be warranted to determine its appropriate clinical use.

Original languageEnglish (US)
Article number1074786
JournalFrontiers in Oncology
Volume12
DOIs
StatePublished - Dec 14 2022

Keywords

  • case report
  • circulating tumor (ctDNA)
  • colon cancer
  • molecular residual disease
  • recurrence
  • stage I

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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