ctDNA Monitoring is a Piece of the Puzzle in CRC Treatment

Season 5, Episode 76,   Oct 31, 2023, 04:00 PM

In this episode of The Vitals, Holly Chitwood, DNP, FNP-C, AGACNP-BC, walks through a patient case with a 70-year-old male with metastatic colorectal cancer.1 His providers used circulating tumor DNA (ctDNA) testing to monitor his minimal residual disease (MRD) levels throughout active treatment. This approach, although not currently addressed in National Comprehensive Cancer Center Guidelines, allows patients and providers to have an idea of how the treatment is working earlier compared with what imaging can usually demonstrate, she explains.

Chitwood is an assistant professor in the College of Nursing at the University of Kentucky, as well as a practicing oncology APRN who primarily cares for patients with gastrointestinal, hepatic-biliary, and sarcoma tumors in her clinic. To read the full case study, please check out our show notes below.

Episode Highlights

“This is a new technology that we have. It is basically looking at what is in your blood to see how much circulating tumor DNA is floating around.”

“In this case, and in a lot of my patients, you will see ctDNA is about, you know, anywhere from 2 to 3 months [ahead], predating what you will see on imaging.”

“You have to be very judicious in explaining the results, especially if you have a positive result, and the patient should be included in the decision making.”

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References

  1. Chitwood H, Myers A. Use of circulating tumor DNA to monitor minimal residual disease among patients with colorectal cancer. Clin J Oncol Nurs. 2023;27(4):369-374. doi:10.1188/23.CJON.369-374