Abstract 484P
Background
Increasing evidence showed that circulating tumor DNA (ctDNA) could be a promising tool in providing molecular, prognostic, predictive and dynamic information in colorectal cancer (CRC) patients. However, it is still poorly and heterogeneously used in clinical practice. The present study aimed to provide a picture of knowledge, practice, attitudes and expectations about ctDNA in CRC.
Methods
An online survey was distributed from November 2019 to January 2020 to French and Italian cooperative and scientific groups of Hepatogastro-enterologists (HGE), Medical Oncologists (MO), Radiotherapists (RT) and Digestive Surgeons (DS). The survey was composed of 15 questions divided in three sections: demographic and professional characteristics, current clinical practice and expectations.
Results
307 physicians completed the survey. Most of them were MO (62%) and HGE (24%). They worked in University Hospital (48%), Cancer Centre (21%), General Hospital (21%) and Private Hospital (10%). Notably, half had access to ctDNA in their daily practice. Of them, 53% used ctDNA to assess RAS/BRAF mutational status only, 46% RAS/BRAF with other mutations and 1% only other mutations. Compared to Italian, French physicians considered ctDNA more useful to determine RAS (P=0.001) or BRAF (P=0.012) mutational status and before anti-EGFR re-challenge (p<0.001), using it more frequently for molecular profiling without biopsy (P=0.016). Italian centers had a better access to ctDNA (P=0.023) using it more frequently for the detection of secondary resistant mutations to target (P=0.042) and for prognostic purposes (<0.001), than French. The main future expectations concerning ctDNA use were: to guide therapeutic strategies in metastatic (Yes vs No, 78%), and adjuvant (Y vs N, 73%) settings, and to profile disease at baseline (Y vs N, 56%).
Conclusions
Half of participants could perform ctDNA in their daily practice. Molecular profiling remains the main goal of ctDNA use to guide initial treatment or re-challenge. Therapeutic strategies based on ctDNA are an expectation for the future, but how to use it routinely remains to be defined.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
C. Gallois: Travel/Accommodation/Expenses: Amgen; Honoraria (self): Sanofi; Honoraria (self): Servier. F. Puglisi: Honoraria (self): Amgen; Honoraria (self): Eli Lilly; Honoraria (self): MSD; Honoraria (self): Novartis; Research grant/Funding (institution): Astrazeneca ; Research grant/Funding (institution): Eisai; Research grant/Funding (institution): Roche; Travel/Accommodation/Expenses: Celgene; Travel/Accommodation/Expenses: Roche; Travel/Accommodation/Expenses: Servier. T. André: Honoraria (self), Advisory/Consultancy, Speaker Bureau/Expert testimony, Research grant/Funding (self), Travel/Accommodation/Expenses: Bristol-Meyers Squibb; Honoraria (self): Chugai; Honoraria (self): GSK; Honoraria (self), Advisory/Consultancy: Pierre Fabre; Honoraria (self), Advisory/Consultancy, Travel/Accommodation/Expenses: Roche/Vantana; Honoraria (self), Advisory/Consultancy: Sanofi; Honoraria (self), Advisory/Consultancy, Speaker Bureau/Expert testimony: Servier; Advisory/Consultancy: Amgen; Advisory/Consultancy: Astra Zeneca; Advisory/Consultancy: Clovis Oncology; Advisory/Consultancy: Gristone Oncology; Advisory/Consultancy: Haliodx; Research grant/Funding (institution), Travel/Accommodation/Expenses: Merck Sharpe Dohme Corp; Advisory/Consultancy: Tesaro; Advisory/Consultancy: Merck Sharpe Dohme Corp. G. Aprile: Advisory/Consultancy: Amgen; Advisory/Consultancy: Baxter; Advisory/Consultancy: Eli Lilly; Advisory/Consultancy: Sanofi; Advisory/Consultancy: Servier. M. Di Maio: Research grant/Funding (institution): Tesaro GSK; Honoraria (self), Advisory/Consultancy: Astra Zeneca; Honoraria (self), Advisory/Consultancy: Pfizer; Honoraria (self), Advisory/Consultancy: Janssen; Honoraria (self), Advisory/Consultancy: Astellas; Honoraria (self), Advisory/Consultancy: Eisai; Honoraria (self), Advisory/Consultancy: Merck Sharp & Dohme; Honoraria (self), Advisory/Consultancy: Takeda. T. Lecomte: Advisory/Consultancy, Travel/Accommodation/Expenses: Amgen; Honoraria (self), Advisory/Consultancy, Travel/Accommodation/Expenses: Servier; Honoraria (self), Advisory/Consultancy: SANOFI; Advisory/Consultancy: Merck Serono. S. Pernot: Honoraria (self), Advisory/Consultancy: Sanofi; Honoraria (self), Advisory/Consultancy: Bayer; Honoraria (self), Advisory/Consultancy: Amgen; Honoraria (self), Advisory/Consultancy: Merck. A. Zaanan: Research grant/Funding (institution): Amgen ; Honoraria (self), Advisory/Consultancy: Baxter; Honoraria (self), Advisory/Consultancy: Merck Serono; Honoraria (self), Advisory/Consultancy: MSD; Advisory/Consultancy, Travel/Accommodation/Expenses: Servier; Honoraria (self), Advisory/Consultancy: Sanofi; Honoraria (self), Advisory/Consultancy: Lilly; Travel/Accommodation/Expenses: Merck. J. Taieb: Speaker Bureau/Expert testimony: Roche; Speaker Bureau/Expert testimony: Merck; Advisory/Consultancy: Amgen; Speaker Bureau/Expert testimony: Celgene; Speaker Bureau/Expert testimony: Servier; Speaker Bureau/Expert testimony: MSD; Speaker Bureau/Expert testimony: Sanofi; Speaker Bureau/Expert testimony: Lilly; Speaker Bureau/Expert testimony: Pierre Fabre. All other authors have declared no conflicts of interest.