The Impact of Liquid Biopsy in Advanced Ovarian Cancer Care
For some time, the presence of circulating tumour DNA (ctDNA) has been shown as a useful marker for many cancers including breast and colon. Testing for ctDNA is readily available by a polymerase chain reaction (PCR), the use of which became commonplace during the Covid pandemic.
Previous studies have shown ctDNA to be present in ovarian cancer. This study looks at whether using ctDNA liquid biopsy improves the management of the cancer, by confirming adequate surgery and earlier detection of recurrence.
Currently the standard marker of active disease is the cancer antigen CA125. There are problems with this in that there is a significant time lag, with persisting elevation of test scores for CA125 after treatment, and delay in a rise to mark recurrence.
ctDNA does clear rapidly from the circulation after complete clearance of cancer, making it a good indicator of adequate surgery, which remains the most significant factor for long survival. Also, in this small group of women (22), ctDNA increase after recurrence was detected several months earlier than CA125 elevation or changes in imaging.
There is a logistic issue due to cost and access, but the use of ctDNA liquid biopsy does offer some promise of improved management for ovarian cancer.
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