32IN - Liquid biopsies and "on treatment" markers

Date 28 September 2014
Event ESMO 2014
Session Advances in precision medicine of metastatic colorectal cancer
Topics Colon and Rectal Cancer
Translational Research
Basic Principles in the Management and Treatment (of cancer)
Presenter Gerald Prager
Citation Annals of Oncology (2014) 25 (suppl_4): iv12-iv13. 10.1093/annonc/mdu296
Authors G. Prager
  • -, Vienna General Hospital (AKH) - Medizinische Universität Wien, 1090 - Vienna/AT




The discovery of molecular mechanisms for malignant transformation, angiogenesis and metastasis formation have opened an abundance of biologic insights and subsequent targeted therapeutic options, which have led to improved prognosis in colorectal cancers. Although this has been found beneficial for many patients with metastasized colorectal cancer, a substantial fraction of patients show secondary resistance after initial response, thus, limiting the clinical benefit of targeted treatment. While assessment of somatic gene alterations from tumor-tissue biopsies is in routine clinical use for targeted treatment in colorectal cancer, it bears inherent limitations. Treatment of colorectal cancer leads to a dynamic molecular alterations due to selective pressure. Thus, a real-time characterization rather than a baseline snap-shot analysis is required. Recent evidence suggest that analysis of cell-free circulating tumor DNA (ctDNA) reflects an accurate, sensitive and specific way to track the molecular tumor dynamic and the individual tumor burden. The advantage of early detection of acquired molecular alterations leading to treatment resistance in colorectal cancer might thereby soon be implemented into clinical routine as determination of ctDNA is cost-effective, less invasive and precise. The advantages as well as the challenges to implement liquid biopsies in to the routine clinical use of colorectal cancer treatment will be discussed.


The author has declared no conflicts of interest.