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The Potential Clinical Utility of Circulating Tumor DNA in Esophageal Adenocarcinoma: From Early Detection to Therapy.

Publication ,  Journal Article
Kosovec, JE; Zaidi, AH; Pounardjian, TS; Jobe, BA
Published in: Frontiers in oncology
January 2018

Esophageal adenocarcinoma (EAC) is a lethal cancer requiring improved screening strategies and treatment options due to poor detection methods, aggressive progression, and therapeutic resistance. Emerging circulating tumor DNA (ctDNA) technologies may offer a unique non-invasive strategy to better characterize the highly heterogeneous cancer and more clearly establish the genetic modulations leading to disease progression. The presented review describes the potential advantages of ctDNA methodologies as compared to current clinical strategies to improve clinical detection, enhance disease surveillance, evaluate prognosis, and personalize treatment. Specifically, we describe the ctDNA-targetable genetic markers of prognostic significance to stratify patients into risk of progression from benign to malignant disease and potentially offer cost-effective screening of established cancer. We also describe the application of ctDNA to more effectively characterize the heterogeneity and particular mutagenic resistance mechanisms in real-time to improve prognosis and therapeutic monitoring strategies. Lastly, we discuss the inconsistent clinical responses to currently approved therapies for EAC and the role of ctDNA to explore the dynamic regulation of novel targeted and immunotherapies to personalize therapy and improve patient outcomes. Although there are clear limitations of ctDNA technologies for immediate clinical deployment, this review presents the prospective role of such applications to potentially overcome many of the notable hurdles to treating EAC patients. A deeper understanding of complex EAC tumor biology may result in the progress toward improved clinical outcomes.

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Published In

Frontiers in oncology

DOI

EISSN

2234-943X

ISSN

2234-943X

Publication Date

January 2018

Volume

8

Start / End Page

610

Related Subject Headings

  • 3211 Oncology and carcinogenesis
  • 3202 Clinical sciences
  • 1112 Oncology and Carcinogenesis
 

Citation

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Kosovec, J. E., Zaidi, A. H., Pounardjian, T. S., & Jobe, B. A. (2018). The Potential Clinical Utility of Circulating Tumor DNA in Esophageal Adenocarcinoma: From Early Detection to Therapy. Frontiers in Oncology, 8, 610. https://doi.org/10.3389/fonc.2018.00610
Kosovec, Juliann E., Ali H. Zaidi, Tamar S. Pounardjian, and Blair A. Jobe. “The Potential Clinical Utility of Circulating Tumor DNA in Esophageal Adenocarcinoma: From Early Detection to Therapy.Frontiers in Oncology 8 (January 2018): 610. https://doi.org/10.3389/fonc.2018.00610.
Kosovec JE, Zaidi AH, Pounardjian TS, Jobe BA. The Potential Clinical Utility of Circulating Tumor DNA in Esophageal Adenocarcinoma: From Early Detection to Therapy. Frontiers in oncology. 2018 Jan;8:610.
Kosovec, Juliann E., et al. “The Potential Clinical Utility of Circulating Tumor DNA in Esophageal Adenocarcinoma: From Early Detection to Therapy.Frontiers in Oncology, vol. 8, Jan. 2018, p. 610. Epmc, doi:10.3389/fonc.2018.00610.
Kosovec JE, Zaidi AH, Pounardjian TS, Jobe BA. The Potential Clinical Utility of Circulating Tumor DNA in Esophageal Adenocarcinoma: From Early Detection to Therapy. Frontiers in oncology. 2018 Jan;8:610.

Published In

Frontiers in oncology

DOI

EISSN

2234-943X

ISSN

2234-943X

Publication Date

January 2018

Volume

8

Start / End Page

610

Related Subject Headings

  • 3211 Oncology and carcinogenesis
  • 3202 Clinical sciences
  • 1112 Oncology and Carcinogenesis