title: Predicting Radiotherapy Responses and Treatment Outcomes Through Analysis of Circulating Tumor DNA.
abstract: Tumors continually shed DNA into the blood where it can be detected as circulating tumor DNA (ctDNA). Although this phenomenon has been recognized for decades, techniques that are sensitive and specific enough to robustly detect ctDNA have only become available recently. Quantification of ctDNA represents a new approach for cancer detection and disease burden quantification that has the potential to revolutionize response assessment and personalized treatment in radiation oncology. Analysis of ctDNA has many potential applications, including detection of minimal residual disease following radiotherapy, noninvasive tumor genotyping, and early detection of tumor recurrence. Ultimately, ctDNA-based assays could lead to personalization of therapy based on identification of somatic alterations present in tumors and changes in ctDNA concentrations before and after treatment. In this review, we discuss methods of ctDNA detection and clinical applications of ctDNA-based biomarkers in radiation oncology, with a focus on recently developed techniques that use next-generation sequencing for ctDNA quantification.
authors.affiliation: Department of Radiation Oncology, Stanford University, Stanford, CA.
authors.forename: Aadel A
authors.initials: AA
authors.lastname: Chaudhuri
authors.affiliation: Department of Radiation Oncology, Stanford University, Stanford, CA.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Binkley
authors.affiliation: Department of Radiation Oncology, Stanford University, Stanford, CA.
authors.forename: Evan C
authors.initials: EC
authors.lastname: Osmundson
authors.affiliation: Division of Oncology, Department of Medicine, Stanford University, Stanford, CA; Division of Hematology, Department of Medicine, Stanford University, Stanford, CA; Institute for Stem Cell Biology and Regenerative Medicine, Stanford University, Stanford, CA; Stanford Cancer Institute, Stanford University. Electronic address: arasha@stanford.edu.
authors.forename: Ash A
authors.initials: AA
authors.lastname: Alizadeh
authors.affiliation: Department of Radiation Oncology, Stanford University, Stanford, CA; Institute for Stem Cell Biology and Regenerative Medicine, Stanford University, Stanford, CA; Stanford Cancer Institute, Stanford University. Electronic address: diehn@stanford.edu.
authors.forename: Maximilian
authors.initials: M
authors.lastname: Diehn
mesh_terms: D014408:Biomarkers, Tumor / Q000097:blood; D004273:DNA, Neoplasm / Q000097:blood*; D006801:Humans; D009369:Neoplasms / Q000097:blood* / Q000532:radiotherapy*; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor; D004273:DNA, Neoplasm