Detection of tumor-derived cell-free DNA from colorectal cancer peritoneal metastases in plasma and peritoneal fluid

  • Iris van't Erve
  • , Koen P. Rovers
  • , Alexander Constantinides
  • , Karen Bolhuis
  • , Emma C.E. Wassenaar
  • , Robin J. Lurvink
  • , Clément J. Huysentruyt
  • , Petur Snaebjornsson
  • , Djamila Boerma
  • , Daan van den Broek
  • , Tineke E. Buffart
  • , Max J. Lahaye
  • , Arend G.J. Aalbers
  • , Niels F.M. Kok
  • , Gerrit A. Meijer
  • , Cornelis J.A. Punt
  • , Onno Kranenburg
  • , Ignace H.J.T. de Hingh
  • , Remond J.A. Fijneman*
  • *Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Tumor-derived cell-free DNA (cfDNA) is an emerging biomarker for guiding the personalized treatment of patients with metastatic colorectal cancer (CRC). While patients with CRC liver metastases (CRC-LM) have relatively high levels of plasma cfDNA, little is known about patients with CRC peritoneal metastases (CRC-PM). This study evaluated the presence of tumor-derived cfDNA in plasma and peritoneal fluid (i.e. ascites or peritoneal washing) in 20 patients with isolated CRC-PM and in the plasma of 100 patients with isolated CRC-LM. Among tumor tissue KRAS/BRAF mutation carriers, tumor-derived cfDNA was detected by droplet digital polymerase chain reaction (ddPCR) in plasma of 93% of CRC-LM and 20% of CRC-PM patients and in peritoneal fluid in all CRC-PM patients. Mutant allele fraction (MAF) and mutant copies per ml (MTc/ml) were lower in CRC-PM plasma than in CRC-LM plasma (median MAF = 0.28 versus 18.9%, p < 0.0001; median MTc/ml = 21 versus 1,758, p < 0.0001). Within patients with CRC-PM, higher cfDNA levels were observed in peritoneal fluid than in plasma (median MAF = 16.4 versus 0.28%, p = 0.0019; median MTc/ml = 305 versus 21, p = 0.0034). These data imply that tumor-derived cfDNA in plasma is a poor biomarker to monitor CRC-PM. Instead, cfDNA detection in peritoneal fluid may offer an alternative to guide CRC-PM treatment decisions.

Original languageEnglish
Pages (from-to)203-208
Number of pages6
JournalThe journal of pathology. Clinical research
Volume7
Issue number3
DOIs
Publication statusPublished - May 2021

Keywords

  • ascitic fluid
  • biomarkers
  • circulating tumor DNA
  • colorectal neoplasms
  • liquid biopsy
  • peritoneum
  • plasma

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