Colon Cancer Micrometastases Identified Through Blood Test

A team from the INCLIVA Health Research Institute, affiliated with the University Clinical Hospital of Valencia, has led a pioneering study that improves the detection of micrometastases in colon cancer through a simple blood test. This breakthrough paves the way for the development of new therapeutic strategies, such as the application of immunotherapy in early stages of the disease.

The findings are collected in the study entitled Whole exome tumor-agnostic ctDNA analysis enhances minimal residual disease detection and reveals relapse mechanisms in localized colon cancer, recently published in the scientific journal Nature Cancer.

The study’s main objective was to improve the early detection of relapse in patients with localized colon cancer (stages II and III) using an advanced, noninvasive technique based on blood tests. This tool allows for more accurate prediction of whether a patient undergoing surgery will develop a relapse, even before it is visible through imaging techniques.

To this end, the team developed a proprietary test—called TAV16 —based on whole-exome sequencing of circulating tumor DNA (ctDNA) present in blood samples. This technique was able to detect the presence of minimal residual disease after surgery with unprecedented sensitivity, allowing researchers to predict which patients are at greatest risk of relapse and which could avoid unnecessary additional treatment.

The analysis was conducted at three key time points: at diagnosis , after surgery, and at the time of relapse . The study included a Spanish cohort of 25 patients and an international validation cohort in Denmark with 15 patients, reinforcing the robustness and reproducibility of the results obtained.

Furthermore, the work integrated complementary techniques such as transcriptomic and proteomic analysis of tumor tissues , which allowed for a deeper understanding of the molecular mechanisms involved in tumor progression and immune system evasion.

One of the study’s key findings is that, in the early stages of colon cancer, the ability of tumor cells to evade the immune response could be a determining factor in patient relapse. This finding, described for the first time, opens a new avenue of research for the use of immunotherapy in early stages of colon cancer, a strategy that had not been considered until now.

Colon cancer is currently a huge challenge

Colorectal cancer represents one of the main challenges in oncology: it is the third most common tumor type worldwide and the second leading cause of cancer-related death, with nearly two million new cases each year. In Spain, more than 44,000 cases are diagnosed annually.

Currently, therapeutic decisions after colon cancer surgery are primarily based on pathological anatomy criteria. This approach has two major limitations: between 30% and 40% of patients considered cured end up suffering a relapse, and between 60% and 70% receive chemotherapy unnecessarily, with the resulting toxic effects and high healthcare costs.

To overcome these limitations, the research team developed a more precise, noninvasive, and widely applicable tool to identify early which patients are at real risk of relapse and allow for early intervention. This tool is the TAV16 test, which significantly improves the sensitivity of current techniques and has the added advantage of not requiring a sample of the primary tumor.

The TAV16 technology was compared with conventional methods, demonstrating significantly superior detection of residual disease, with a sensitivity ranging from 87% to 100%. Furthermore, it has high potential for technology transfer and is already patented.

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(Featured image by National Cancer Institute via Unsplash)

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First published in GACETA MEDICA. A third-party contributor translated and adapted the article from the original. In case of discrepancy, the original will prevail.

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