We asked 5 top KOLS at ASCO GI 2024 the same questions on MRD and CTDNA testing. You might be surprised by the diverse answers.
- Which MRD-guided trials are you most excited to hear about this year at ASCO GI?
- In which clinical setting do you believe ctDNA testing has the greatest opportunity to help improve patient management?
- Anything else you want to add when it comes to using MRD testing for patients with CRC?
Investigating MRD and ctDNA Testing: Insights from Top KOLs at ASCO GI 2024
Introduction
The landscape of oncology research is continually shaped by advancements in minimal residual disease (MRD) and ctDNAtesting (circulating tumor DNA), particularly in colorectal cancer. The American Society of Clinical Oncology Gastrointestinal Cancers Symposium (ASCO-GI) serves as a pivotal platform for sharing groundbreaking research and clinical insights among oncologists and researchers. We asked five top Key Opinion Leaders (KOLs) at ASCO GI 2024 the same questions on MRD and ctDNA testing, yielding diverse and enlightening responses.
Key Insights from Christopher Lieu, MD
Christopher Lieu, MD, Associate Director for Clinical Research, co-Director, Gastrointestinal Medical Oncology at University of Colorado
Exciting MRD-Guided Trials
Dr. Lieu emphasizes the significance of observational data from trials like Bespoke and updates from the Galaxy study. These trials offer invaluable insights into ctDNA dynamics post-resection and its implications for patient outcomes.
Clinical Settings for ctDNA Testing
Dr. Lieu identifies the greatest opportunity for ctDNA testing in low-risk stage two colon cancer, where the decision to administer chemotherapy is challenging. He advocates for personalized treatment approaches guided by ctDNA status, empowering patients and physicians with shared decision-making tools.
Enhancing Patient Care with MRD Testing
Dr. Lieu underscores the transformative potential of ctDNA testing in refining treatment approaches and improving patient outcomes. While acknowledging the need for further research, he emphasizes the importance of evidence-based practice and active participation in clinical trials.
Sakti Chakrabarti, MD, GI oncologists from University Hospitals, in Cleveland part of the Case Comprehensive Cancer Center
Insights from Sakti Chakrabarti, MD
Advancements in Cancer Treatment
Dr. Chakrabarti highlights updates from the Galaxy study and the bespoke trial, signaling promising avenues for cancer management. He stresses the importance of integrating ctDNA-based platforms into routine clinical practice to optimize patient care.
Utilizing ctDNA in Clinical Practice
Dr. Chakrabarti emphasizes the role of ctDNA testing in assessing minimal residual disease and guiding treatment decisions. He underscores its prognostic significance and potential to revolutionize patient management across various clinical settings.
Collaborative Efforts and Future Directions
Dr. Chakrabarti calls for collaborative efforts and active participation in clinical trials to advance our understanding of ctDNA testing. He envisions a future where ctDNA analysis becomes an indispensable tool in personalized cancer management.
Howard S. Hochster, MD, Associate Director for Clinical Research and Director, GI Oncology, Rutgers Cancer Institute; distinguished Professor of Medicine.
Insights from Howard S. Hochster, MD
Advancements in MRD-Guided Trials
Dr. Hochster highlights the anticipated trials at ASCO GI 2024, including updates from the Galaxy study and the Bespoke trial. These trials aim to elucidate the prognostic significance of ctDNA assays and optimize adjuvant chemotherapy regimens.
Clinical Applications of ctDNA Testing
Dr. Hochster discusses the challenges and opportunities in integrating ctDNA testing into clinical practice. He emphasizes the need for rigorous clinical trials to determine the optimal stage and setting for ctDNA utilization.
Future Perspectives
Dr. Hochster envisions a future where ctDNA testing becomes a standard practice in oncology, offering personalized treatment approaches and improved patient outcomes. He underscores the importance of collaborative research efforts and evidence-based practice in realizing this vision.
Jeanne Tie, MD, Medical Oncology Lead for the Lower GI tumour stream at Peter MacCallum Cancer Centre and a senior research fellow within the division of personalised oncology at the Walter and Eliza Hall Institute
Insights from Jeanne Tie, MD
Anticipated Trials and Advancements in ctDNA Testing
Dr. Tie discusses the significance of upcoming trials like COBRA and the Bespoke study in advancing our understanding of ctDNA testing. She emphasizes the importance of real-world data and patient perspectives in shaping future treatment paradigms.
Clinical Applications of ctDNA Testing
Dr. Tie identifies clinical scenarios where ctDNA testing holds promise in guiding treatment decisions, particularly in situations where the benefit of chemotherapy is uncertain. She underscores the potential of ctDNA testing in improving patient outcomes and refining treatment approaches.
Addressing Challenges and Limitations
Dr. Tie acknowledges the challenges and limitations associated with ctDNA assays and emphasizes the importance of ongoing clinical trials and collaboration within the medical community. She calls for continued research efforts to optimize the use of ctDNA testing in patient care.
Stacey A. Cohen, MD, an Associate Professor, Clinical Research Division at Fred Hutch Cancer Center, and University of Washington in Seattle
Insights from Stacey A. Cohen, MD
Advancements in ctDNA Testing
Dr. Cohen shares her enthusiasm for the burgeoning field of ctDNA testing and its potential to revolutionize cancer care. She highlights the significance of ongoing trials and advancements in integrating ctDNA testing into standard clinical workflows.
Utilizing ctDNA in Clinical Practice
Dr. Cohen discusses the clinical applications of ctDNA testing in post-therapy settings and personalized treatment decision-making. She envisions a future where ctDNA analysis becomes an indispensable tool in guiding treatment choices and improving patient outcomes.
Future Directions and Collaborative Efforts
Dr. Cohen emphasizes the importance of collaborative research efforts and evidence-based practice in realizing the full potential of ctDNA testing. She calls for continued participation in clinical trials and active engagement within the medical community to advance the field of oncology.
Conclusion
The insights gleaned from these top KOLs at ASCO GI 2024 underscore the transformative potential of MRD and ctDNA testing in revolutionizing cancer care. By leveraging technological advancements and embracing collaborative research efforts, clinicians can harness the power of ctDNA analysis to personalize treatment approaches and improve patient outcomes. As the field continues to evolve, ongoing clinical trials and evidence-based practice will play a crucial role in realizing the full potential of MRD and ctDNA testing in oncology.