How ctDNA Changing the Landscape of Management of Colorectal Cancers

Colorectal cancer (CRC) continues to be one of the common causes of cancer-related deaths. A significant proportion of surgically cured CRC patients’ relapse and if these recurrences are not resectable, they carry a poor prognosis. Despite advances in cancer treatment with targeted monoclonal antibodies, only minority benefit. At present, tissue biopsy, imaging and serum tumour markers are standard of care in the management. There is a constant need for novel biomarkers to improve risk stratification, pickup recurrences early and selection of therapy. Cellular contents of cancer cells, including their DNA, are continuously shed into circulation. This non-invasive blood-based genotyping of circulating tumour DNA (ctDNA) appears to provide genetic information similar to tumour tissue molecular profiling. Besides, ctDNA can be quantified and levels may be used to assess tumour burden. Here, we review several emerging clinical applications of ctDNA in parallel to the standard of care to improve the management of CRC.