Liquid Biopsy Shows Promise for Early-Onset Colorectal Cancer
Douglas K. Rex, MD, MASGE, reviewing Nakamura K, et al. Gastroenterology 2022 Jul 15.
Early-onset colorectal cancer (EOCRC), or CRC occurring before age 50, is associated with advanced tumor stage at diagnosis, distal colon location, and signet ring histology. Thus, EOCRC may be biologically unique compared with late-onset CRC (LOCRC).
In an exploratory study, investigators identified a microRNA (miRNA) panel of 4 miRNAs that were unique to EOCRC, relative to LOCRC, and detectable in plasma samples. The investigators evaluated this blood-based panel in a training cohort of Japanese patients with EOCRC (n=72) and controls (n=45), and a validation cohort (77 with EOCRC; 65 controls) from Spain. In these cohorts, the sensitivity of the assay was 90% and 82%, respectively, and the specificity was 80% and 86%. Both early- and late-stage EOCRC were detected. The investigators also showed that the abnormal miRNAs disappeared from serum after surgical resection of tumors and that the assay performed well in detecting LOCRC, despite the investigators selecting the miRNAs for their association with EOCRC.
COMMENTThis assay will require vigorous prospective clinical testing to understand its performance, but it’s another signal that we are approaching the era of blood-based liquid biopsy screening for CRC. This study does not provide insight into its performance for detecting adenomas or serrated lesions.
Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.
CITATION(S)
Nakamura K, Hernández G, Sharma GG, et al. A liquid biopsy signature for the detection of patients with early-onset colorectal cancer. Gastroenterology 2022 Jul 15. (Epub ahead of print) (https://doi.org/10.1053/j.gastro.2022.06.089)
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