Can Can ctD ctDNA be used as as a a Mark arker of of Minimal al R Residual al Di Diseas ase to Di Direct ct Adjuvan Ad ant t Th Therapy i y in Col Colon on Can Cance cer? r? Pashtoon Kasi, MD, MS Assistant Professor College of Medicine and Oncology Holden Comprehensive Cancer Center University of Iowa pashtoon-kasi@uiowa.edu @pashtoonkasi
Disclosures • Consultancy/Advisory Board (to institution) • Taiho Oncology • Ipsen • Research/Trial Support (to institution) • BMS • Celgene • Astrazeneca • BTG • Advanced Accelerator Applications • Array Biopharma
> 270 abstracts ASCO19
August 2018 Volume 24, Issue 15
CtDNA Diagnosis Minimal Residual Disease Treatment Response Acquired Resistance
Can we reliably Does it detect CtDNA in correspond with outcomes patients with (recurrence)? colorectal cancer?
Analysi sis o s of Plasm sma Cell ell-Fr Free D ee DNA by by Ultrade deep p Seque uenc ncing ng i in Patien ents W s With Stages I I to III III Colorec ectal C Canc ncer er
Analysis of Plasma Cell-Free DNA by Ultradeep Sequencing in Patients With Stages I to III Colorectal Cancer
Analysi sis o s of Plasm sma Cell ell-Fr Free D ee DNA by by Ultrade deep p Seque uenc ncing ng i in Patien ents W s With Stages I I to III III Colorec ectal C Canc ncer er
Circulating t g tumor or DNA analy lysis is d detects minim imal l resid idual l diseas ease a e and p pred edicts recurren ence i e in pat atien ents with s stage I II colon ca cancer
Circulating t g tumor or DNA analy lysis is d detects minim imal l resid idual l diseas ease a e and p pred edicts recurren ence i e in pat atien ents with s stage I II colon ca cancer
Circul ulating ng mut utant DN DNA to a o assess ss tumo mor dynam amic ics
At diagnosis, ctDNA is a more sensitive biomarker Colorectal Reinert et al. JAMA Oncology than CEA in colorectal cancer CtDNA Detection at Diagnosis CEA Detection at Diagnosis Reinert T, Henriksen TV, Christensen E, et al. Analysis of plasma cell-free DNA by ultradeep sequencing in patients with stages I to III colorectal cancer [published online ahead of print May 9, 2019]. JAMA Oncol. 2019. doi:10.1001/jamaoncol.2019.0528.
CtDNA+ 3 vs. 6 months of therapy – IDEA FRANCE
CtDNA+ 3 vs. 6 months of therapy
Summary/Future Directions
T4 High risk N2 Node positive MSI- Mismatch repair deficiency High
T4 High risk N2 Node positive MSI- Mismatch repair deficiency High
Can Can ctD ctDNA be used as as a a Mark arker of of Minimal al R Residual al Di Diseas ase to Di Direct ct Adjuvan Ad ant t Th Therapy i y in Col Colon on Can Cance cer? r? Pashtoon Kasi, MD, MS Assistant Professor College of Medicine and Oncology Holden Comprehensive Cancer Center University of Iowa pashtoon-kasi@uiowa.edu @pashtoonkasi
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