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ASCO GI 2024 | Significance of ctDNA in assessing MRD and novel strategies in gastrointestinal cancers

Anup Kasi, MD, MPH, from the University of Kansas Cancer Center, discusses the significance of circulating tumor DNA (ctDNA) in assessing minimal residual disease (MRD) and predicting recurrence in colon cancer. While it’s now standard for colon cancer patients to undergo MRD evaluation using ctDNA after resection and chemotherapy, its role in other gastrointestinal cancers like pancreatic cancer is still evolving. Studies have shown that detectable ctDNA post-surgery and adjuvant therapy in pancreatic cancer patients indicates a high risk of recurrence. However, challenges remain in treating MRD-positive patients with limited options beyond chemotherapy. Dr. Kasi highlights ongoing clinical trials like the Phase II TESLA trial (NCT05638698), which investigates a vaccine against Kras combined with a PD-1 checkpoint inhibitor for pancreatic cancer patients who are ctDNA positive post-surgery and adjuvant therapy. Such novel treatment strategies aim to target circulating tumor cells and improve survival outcomes. This interview took place at the 2024 ASCO Gastrointestinal (GI) Cancers Symposium in San Francisco, CA.

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