Sensitivity of a blood ctDNA-based multimodal test for the detection of advanced colorectal neoplasms

Blood-based screening tests for colorectal cancer (CRC) could be particularly useful for population-based screening as they could be easily implemented in routine medical care. However, so far available blood-based tests did not reach sufficient accuracy to be competitive with established noninvasive CRC screening tests, such as fecal immunochemical tests (FITs). 1 Shaukat A. Levin T.R. Current and future colorectal cancer screening strategies. Nat Rev Gastroenterol Hepatol. 2022; 19: 521-531 Crossref PubMed Scopus (86) Google Scholar The study by Bessa and colleagues provides a valuable contribution to exploring the diagnostic accuracy of a novel multimodal circulating tumor DNA (ctDNA)-based blood assay that integrates genomics, epigenomics and fragmentomics (as well as proteomics in refined version) to detect CRC and its precursors. 2 Bessa X. Vidal J. Balboa J.C. et al. High accuracy of a blood ctDNA-based multimodal test to detect colorectal cancer. Ann Oncol. 2023; 34: 1187-1193 Abstract Full Text Full Text PDF PubMed Scopus (2) Google Scholar Bessa et al. report sensitivities of 93% for detecting CRC and 85% for detecting overall advanced colorectal neoplasia (ACN, including CRC and advanced precancerous lesions, respectively). These sensitivities are far higher than those reported for previously proposed blood-based tests, such as the methylated septin 9 assay, the first blood-based CRC screening test approved by the United States Food and Drug Administration. 3 Church T.R. Wandell M. Lofton-Day C. et al. Prospective evaluation of methylated SEPT9 in plasma for detection of asymptomatic colorectal cancer. Gut. 2014; 63: 317-325 Crossref PubMed Scopus (578) Google Scholar High accuracy of a blood ctDNA-based multimodal test to detect colorectal cancerAnnals of OncologyVol. 34Issue 12PreviewDetection of circulating tumor DNA (ctDNA) is a minimally invasive and convenient blood-based screening strategy that may increase effectiveness of colorectal cancer (CRC) screening. Full-Text PDF Open Access