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    Early stage NSCLC - challenges to implementing ctDNA-based screening and MRD detection.

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    Authors
    Abbosh, Christopher
    Birkbak, Nicolai J
    Swanton, Charles
    Affiliation
    Cancer Research UK Lung Cancer Centre of Excellence London and Manchester, University College London Cancer Institute, London, UK
    Issue Date
    2018-07-03
    
    Metadata
    Show full item record
    Abstract
    Circulating tumour DNA (ctDNA) refers to the fraction of cell-free DNA in a patient's blood that originates from a tumour. Advances in DNA sequencing technologies and our understanding of the molecular biology of tumours have resulted in increased interest in exploiting ctDNA as a tool to facilitate earlier detection of cancer and thereby improve therapeutic outcomes by enabling early intervention. ctDNA analysis might also have utility in the adjuvant therapeutic setting by enabling the identification of patients at a high risk of disease recurrence on the basis of the detection of post-surgical minimal (or molecular) residual disease (MRD). This approach could provide the capability to adapt clinical trials in the adjuvant setting in order to optimize risk stratification, and we argue that this objective is achievable with current technologies. Herein, we evaluate contemporary next-generation sequencing (NGS) approaches to ctDNA detection with a focus on non-small-cell lung cancer. We explain the technical and analytical challenges to low-frequency mutation detection using NGS-based ctDNA profiling and evaluate the feasibility of ctDNA profiling in both screening and MRD assessment contexts.
    Citation
    Early stage NSCLC - challenges to implementing ctDNA-based screening and MRD detection. 2018 Nat Rev Clin Oncol
    Journal
    Nature Reviews Clinical Oncology
    URI
    http://hdl.handle.net/10541/621151
    DOI
    10.1038/s41571-018-0058-3
    PubMed ID
    29968853
    Type
    Article
    Language
    en
    ISSN
    1759-4782
    ae974a485f413a2113503eed53cd6c53
    10.1038/s41571-018-0058-3
    Scopus Count
    Collections
    All Paterson Institute for Cancer Research

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