ArticleCancers2024
Circulating Tumor DNA for Prediction of Complete Pathological Response to Neoadjuvant Radiochemotherapy in Locally Advanced Rectal Cancer (NEORECT Trial).
Article in Cancers, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- Genomic, transcriptomic, and molecular predictors of response to neoadjuvant therapy in locally advanced rectal cancer: a narrative review.Medical oncology (Northwood, London, England) · 2026Review
- Prognostic and Predictive Role of Circulating Tumor DNA in Locally Advanced Rectal Cancer Managed With Total Neoadjuvant Therapy: A Systematic Review.Health science reports · 2026Review
- Watch-and-wait in rectal cancer: A critical appraisal of promise, perils and unresolved contours of organ preservation (Review).Oncology letters · 2026Review
- Practical integration of ctDNA-defined minimal residual disease in gastrointestinal cancers: testing windows and evidence-aligned management frameworks.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026Review
- Significant Correlation of Dynamic Pan-Immune Inflammation Value and Magnetic Resonance Imaging Response in Patients with Locally Advanced Rectal Cancer Treated with Total Neoadjuvant Therapy.Current oncology (Toronto, Ont.) · 2026Article
- Optimising response assessment to neoadjuvant therapy in rectal cancer to reduce the incidence of ypT0N0 resection.International journal of colorectal disease · 2026Article
- Integration of Nanotechnology with ctDNA: New Advances for Monitoring Neoadjuvant Chemotherapy.International journal of nanomedicine · 2026Review
- Predicting pathological complete response after neoadjuvant chemoradiotherapy in rectal cancer: beyond morphologic MRI.International journal of colorectal disease · 2025Article
- Article
- Early Dynamics of Circulating Tumor DNA Following Curative Hypofractionated Radiotherapy Related to Disease Control in Lung Cancer.Diagnostics (Basel, Switzerland) · 2025Article
Corrections and comments
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Authors and funding
15 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND/
objectivesLocally advanced rectal cancer is treated with neoadjuvant chemoradiotherapy (nCRT) followed by total mesorectal excision (TME). As this approach achieves complete pathologic remissions (pCR) in approximately 30% of patients, it raises the question of whether surgery is always necessary. Non-surgical strategies, such as "watch and wait" (W&W), have shown similarly promising outcomes. However, there is an unmet need for reliable biomarkers predicting pCR. Analysis of circulating tumor DNA (ctDNA) has shown potential for monitoring treatment response and detecting minimal residual disease. We hypothesized that monitoring ctDNA changes during nCRT might facilitate the identification of individuals who achieve pCR.
methodsIn the prospective single-center NEORECT trial, the plasma of forty rectal cancer patients was collected before, during, and after nCRT and before TME. Informative somatic mutations were identified in tissue biopsies by NGS and subsequently used for ctDNA quantification by dPCR.
resultsThe results identified three distinct ctDNA patterns: increase, decrease, and absence. Remarkably, undetectable DNA was observed in good responders, while a tenfold ctDNA increase was associated with the emergence of new metastases. Despite these insights, ctDNA alone demonstrated low specificity, with no significant correlation to pCR or long-term prognosis. A multimodal approach incorporating routinely available clinical parameters remains inadequate for accurately predicting pCR prior to TME.
conclusionsIn conclusion, the NEORECT trial establishes the feasibility of ctDNA-based personalized monitoring for rectal cancer patients undergoing nCRT. However, the utility of ctDNA in enhancing pCR prediction for a W&W strategy warrants further investigation. Larger studies integrating multi-gene analyses and expanded clinical datasets are essential in the future.
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