Circulating tumor DNA for diagnosis, prognosis and treatment of gastrointestinal malignancies

Table 1 Detection rates and impact on outcome of circulating tumor DNA in gastrointestinal cancer

Entity	Detection rate	Common target	OS ctDNA −/ +	PFS ctDNA −/ +
mPDAC	67%-75%[43]	> 90% KRAS, but also TP53, SMAD4	8.4 vs 3.2[89]	5 vs 3.9[43]
lPDAC	21%-69%[42]		16.3 vs 5.8[57]	19 vs 8[57]
mCRC	> 90%[79]	KRAS, NRAS, BRAF, PIK3CA, NRAS, APC, TP53, EGFR, ERBB3/4	36.5 vs 17.1[90]	RAS 8.3 vs BRAF 4.5 vs wild-type 22.9[72]
lCRC	73%(43%-80%)[62,63]		-	87% vs 33%[65]
				3-yr PFS
mUGIC	87.5%[21]	TP53, HER2, MET, EGFR, KRAS	13.7 vs 8.6[20]	7.4 vs 4.9[83]
lUGIC	20%[19]		66.9 vs 37.7[10]	12.5 vs not reached[20]
HCC	56.3%[24]	TP53, CTNNB1, TERT	61% vs 24%[29]	47% vs 22%[29]
			3-yr OS	3-yr PFS
mIHCC	92%[28]	TP53, KRAS, ARID1A	16.4 vs 7.4[91]	8.2 vs 4.6[91]
mEHCC	55%[28]		NS[28]	NS[28]

−/+: ctDNA negative/positive; ctDNA: Circulating tumor DNA; HCC: Hepatocellular carcinoma; lCRC: Localized colorectal carcinoma; lPDAC: Localized pancreatic ductal adenocarcinoma; lUGIC: Localized upper gastrointestinal carcinoma; mCRC: Metastatic colorectal carcinoma; mEHCC: Metastatic extrahepatic cholangiocarcinoma; mIHCC: Metastatic intrahepatic cholangiocarcinoma; mPDAC: Metastatic pancreatic ductal adenocarcinoma; mUGIC: Metastatic upper gastrointestinal carcinoma; NS: Not significant; OS: Overall survival in months; PFS: Progressive-free survival in months.