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CtDNA screening tests and the CIRCULATE-US trial: Dr. Lieu

Doc Talks

In this DocTalk, Dr. Chris Lieu goes over CRC screening tests, including newer DNA-based tests that focus on CRC and multi-cancer early detection tests.

In the second part of his talk, he covers the CIRCULATE-US trial for high-risk stage II and III colon cancer patients, which as of May 2022 is currently enrolling. This trial will address questions around the clinical utility of Minimal Residual Disease ctDNA testing.

Recorded with Paltown Scientific Director Dr. Manju George in May, 2022. 

Table of contents

00:00: Introduction
01:19: Objectives
02:35: Colorectal Cancer 101
02:45: CRC Stats 101
03:04: Risk factors for CRC
04:14: Incidence of CRC
05:59: Take home point
06:45: CRC screening
07:03: ACS screening recommendations & tests
08:10: USPSTF screening guidelines
08:50: Take home point
09:38: Role of family history of polyps in screening
10:46: Predictors of CRC screening rates?
12:45: Tumor DNA-based screening approaches for CRC
14:01: Stool-based DNA testing
16:09: Intro to liquid biopsies
16:36: CtDNA: Properties & terms
17:40: CtDNA: Advantages
18:13: CtDNA: Disadvantages
19:27: Take home point
19:45: CEA vs ctDNA
20:44: CRC specific ctDNA testing
21:00: LUNAR-2 assay: The test, sensitivity & specificity
22:50 the 12,000 patient Guardant ECLIPSE trial
23:40: Multi-cancer Early Detection Tests, how do they work?
25:36: The 15,000 patient CCGA study
28:06: Take home point
29:01: Minimal Residual Disease (MRD) & ctDNA kinetics
31:15: Are findings of a ctDNA test actionable?
32:15: Adjuvant chemo for stage III colon cancer: Room for improvement
33:00: CIRCULATE-US
34:04: Is ctDNA in CRC ready for primetime?
34:55: Final thoughts
35:20: Q&A — Patient selection for Stage II Colon cancer
36:50: Q&A — Locations?
37:30: Q&A — How can patients talk to their care team about CIRCULATE US?
39:50: Q&A — How to enroll, info for patients interested.
40:50: Q&A — How to identify the different kinds of liquid biopsy or ctDNA tests? MRD vs others
42:13: Q&A — Trial for colon and rectal?
43:00: Q&A — What affects test sensitivity?
45:00 Q&A — Costs?