GI Malignancies Debate 2023 - Chicago | Limitations of ctDNA analysis in predicting recurrence of GI malignancies

Suneel Kamath, MD, Cleveland Clinic, Cleveland, OH, discusses two key limitations associated with the use of ctDNA tests in predicting recurrence of GI malignancies. Presently, ctDNA tests are effective positive predictors of recurrence. However, the first key challenge relates to the 30-40% of people who return a negative ctDNA test but still have recurrence in subsequent years. Presently, not enough is known to be able to identify such individuals so as to provide continual treatment and prevent recurrence. The second limitation arises in advanced-stage settings and recurrence monitoring. Patients may present with a positive ctDNA test while scans don’t identify the presence of any tumor. In this case, while a different imaging modality could be employed for clarification, patients still have a high recurrence probability, but the question is raised of whether premature treatment should be undertaken at that time point, even though it may not improve their life span. This interview took place at the Great Debates and Updates GI Malignancies Debate in Chicago, IL.

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