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Molecular Residual Disease and Adjuvant Trial Design in Solid Tumors.

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Date
2019-10
ICR Author
Coakley, Maria
Turner, Nicholas
Garcia-Murillas, Isaac
Author
Coakley, M
Garcia-Murillas, I
Turner, NC
Type
Journal Article
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Abstract
Advances in diagnosis and treatment have resulted in a high rate of survival for many patients with early-stage cancers. However, identifying who is at ongoing risk of relapse remains of high priority to direct subsequent adjuvant therapy. Multiple recent retrospective studies have shown that detection of tumor-derived materials in blood, in particular with circulating tumor DNA (ctDNA) analysis, can identify patients with residual disease before clinical or radiological evidence of metastatic disease, anticipating relapse with relatively high sensitivity and high specificity. We discuss how these emerging technologies are defining new subgroups of patients with "Molecular Residual Disease" and "Molecular Relapse." We outline how novel clinical trials in the adjuvant setting designed for these new subgroups of patients may improve selection for adjuvant therapies, and provide new surrogate endpoints that may allow for early registration of adjuvant therapies and novel clinical trial designs in the adjuvant setting. We discuss the current limitations of these techniques and the routes to clinical implementation.
URI
https://repository.icr.ac.uk/handle/internal/3221
DOI
https://doi.org/10.1158/1078-0432.ccr-19-0152
Collections
  • Breast Cancer Research
Subject
Humans
Neoplasms
Neoplasm Recurrence, Local
Neoplasm, Residual
Antineoplastic Agents
Prognosis
Treatment Outcome
Chemotherapy, Adjuvant
Risk Assessment
Research Design
Clinical Trials as Topic
Biomarkers, Tumor
Circulating Tumor DNA
Research team
Molecular Oncology
Language
eng
Date accepted
2019-05-09
License start date
2019-10
Citation
Clinical cancer research : an official journal of the American Association for Cancer Research, 2019, 25 (20), pp. 6026 - 6034

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