2 ms·
Would you say ctDNA tools are sensitive and specific enough now to be able to make a decision about post op adjuvant therapies? “Now that I’ve had surgery, did
by edwardog 1y ago
Would you say ctDNA tools are sensitive and specific enough now to be able to make a decision about post op adjuvant therapies? “Now that I’ve had surgery, did the R0 resection get it all, or do I need to do chemo and challenging medication like mitotane?”
- mbreese 1y agoI’ve seen it most commonly thought of as using ctDNA to detect relapse earlier. So, more like — did the tumor come back? And if that does happen, with ctDNA, can you detect that there is a relapse before you would otherwise find it with standard imaging. Most studies I’ve seen have shown that this happens and ctDNA is a good biomarker for early detection of relapse. The case for proactively looking for circulating tumor DNA without an initial diagnosis or underlying genetic condition is a bit dicier IMHO. For example, what if really like to know (I haven’t read this article, but I’m pretty familiar with the field) is how many people had a detectable cancer in their plasma (ctDNA), but didn’t receive a cancer diagnosis. It’s been known for a while that you can detect precancerous lesions well before a formal cancer diagnosis. But, what’s still an open question AFAIK, is how many people have precancerous lesions or positive ctDNA hits that don’t form a tumor? (I’ve done a little work in this area)
- refurb 1y agoIt seems like adjuvant treatment is rather routine at this point? And the question would be “do I believe the test when it tells me the cancer is gone?” When you know it’s not 100% accurate? Or do you always do the adjuvant treatment considering the very small chance the test is wrong has a very high cost (death)?