CTdna

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polluxx
Posts: 59
Joined: Thu Jul 10, 2008 9:41 pm

CTdna

Postby polluxx » Thu Dec 24, 2020 12:30 pm

I just got a clean PET scan and my oncologist said I will continue getting one every 3 months. I’m supposed to get my CEA taken every 3 months, but it isn’t a good indicator for me. It was less than 2 before my surgery when I had a heavy tumor load in my body.

I wanted to get CTdna tests instead, but my insurance won’t cover it.

I was happy that my oncologist was able to get me into a study with Signitura and I’m going to have a phlebotomist come to the house every 3 moths and draw blood for the CTdna test at no cost.

Hopefully, this we’ll help me not be anxious about a recurrence and not worry unless the tests tell us we have something to worry about.
Stage 3c
2/2020 Right colon hemicolectomy (invasive adenocarcinoma with micropillary features)
Moderately differentiated
Tumor size: 4.4 in greatest dimension Metastatic Carcinoma in 12 out of 28 lymph nodes
Extranodal extension identified
Margins negative

3/2020 Began 12 rounds of FolFox
9/2020 Finished FolFox
12/2020 PET Scan-NED
1-2021 CTdna test

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beach sunrise
Posts: 356
Joined: Thu Mar 05, 2020 7:14 pm

Re: CTdna

Postby beach sunrise » Thu Dec 24, 2020 12:58 pm

Way to go after it with the ctDNA!!!
Merry Christmas!
8/19 RC CEA 82.6 T3N0M0
Neoadj 5FU/rad 6 wk
Surg 1/20 APR - margins T4bN1a IIIC G2 MSI- 1/20 LN+ LVI+ PNI-
pre cea 24/post 5.9
FOLFOX
8 rds 6-10 CEA 11.4 4 more no oxa
7/20 CEA 11.1, 8.8
8/20 CEA 7.8
9/20 CEA 8.8, 9, 8.6
10/20 CEA 8.1
11/20 CEA 8's
12/20 CEA 8's & 9's
ADAPT+++ TM drug. Adding Everolimus soon.
MHL1+
PMS2+
MSH2+
MSH6+
POLD1
Chem-sens test NCI "Test failed, neo adj CR worked. Not enough ca cells to test"

LynnMarie
Posts: 2
Joined: Thu Feb 20, 2020 2:52 pm
Facebook Username: Lynn M Frankel
Location: Baltimore, MD

Re: CTdna

Postby LynnMarie » Mon Jan 04, 2021 10:53 am

Can you share any details about the Signatera study? I would love to enroll! Thanks!
Fem, 51 yo at DX CRC Stage IIIa
3 cm tumor removed from sigmoid during colonoscopy 1/10/20 (51 yo)
adenocarcinoma, poorly differentiated
colon resection 2/4/20 = 1 of 18 lymph nodes positive
port 3/1/20
Genetic testing: MSS KRAS G12V
FOLFOX 3/4 - 8/14/20 (last 5 no oxi because of allergic reaction)
CEA: 1/22: 2.5; 3/4: 2.14; 7/15: 1.4, 11/13: 4.11; 12/7: 2.81
CT Scan 8/12 NED
Now what?

JJH
Posts: 292
Joined: Mon Apr 24, 2017 7:26 am

CTdna study: Overview and Enrollment

Postby JJH » Tue Jan 05, 2021 11:42 am

LynnMarie wrote:Can you share any details about the Signatera study? I would love to enroll! Thanks!


ctDNA Signatera overview:
Signatera is a custom-built circulating tumor DNA (ctDNA) test that received the FDA Breakthrough Device Designation in 2019

US-based cell-free DNA testing company Natera has started enrolment for two clinical trials, dubbed CIRCULATE-Japan and BESPOKE CRC, to measure clinical outcomes of Signatera molecular residual disease (MRD) testing for resectable stages II-IV colorectal cancer (CRC).

Reference: https://www.nsmedicaldevices.com/news/natera-signatera-mrd-testing/


ctDNA study enrollment:
BESPOKE Study of ctDNA Guided Therapy in Colorectal Cancer
Brief Summary:

The BESPOKE CRC study will prospectively enroll patients who have undergone surgery for stage II or III colorectal cancer (CRC) and who have residual formalin-fixed paraffin-embedded (FFPE) tissue available will provide FFPE and whole blood samples. Patients will receive SIGNATERA™ test results and may be recommended for adjuvant chemotherapy or observation by their treating clinician. Patients will be followed for up to two years with periodic whole blood collection. The study also has a control arm that will consist of matched Stage II or Stage III CRC cases that have a minimum of least 2 years clinical follow-up data.

Reference: BESPOKE CRC clinical trial: NCT04264702
"The darkest hour is just before the dawn" - Thomas Fuller (1650)

polluxx
Posts: 59
Joined: Thu Jul 10, 2008 9:41 pm

Re: CTdna

Postby polluxx » Tue Jan 05, 2021 12:02 pm

Thank you for looking that up! I was going to call my contact person at Signitera today and try to get more info.

I wasn’t given very many details. My doctor said that after I asked for the test, she went to a webinar about it and discovered that someone from John Muir was participating in the study so she was able to sign me up.

They mailed a blood collection kit to my house, a mobile phlebotomist came to the house and drew 8 vials to mail to the lab. I’m supposed to see results via my portal in a matter of days.

I’ll update when I learn more.
Stage 3c
2/2020 Right colon hemicolectomy (invasive adenocarcinoma with micropillary features)
Moderately differentiated
Tumor size: 4.4 in greatest dimension Metastatic Carcinoma in 12 out of 28 lymph nodes
Extranodal extension identified
Margins negative

3/2020 Began 12 rounds of FolFox
9/2020 Finished FolFox
12/2020 PET Scan-NED
1-2021 CTdna test

polluxx
Posts: 59
Joined: Thu Jul 10, 2008 9:41 pm

Re: CTdna

Postby polluxx » Wed Jan 06, 2021 12:54 pm

I spoke to my patient coordinator yesterday. He told me that the best thing a patient can do is to tell their oncologist that they want to have the ctDNA blood test and have the doctor contact Signitera to find a study.

He sent me a couple of links about the process that might be interesting to people searching in the future who find this thread. He also told me this first test will take 3 weeks at least because it takes time to compare my blood test to the tissue sample, but future ones should have about a 10 day turn around.

https://www.natera.com/oncology

https://www.youtube.com/watch?v=nIHnvtkwq30

https://www.kwqc.com/content/news/Unive ... 36931.html

I hope this helps a little.
Stage 3c
2/2020 Right colon hemicolectomy (invasive adenocarcinoma with micropillary features)
Moderately differentiated
Tumor size: 4.4 in greatest dimension Metastatic Carcinoma in 12 out of 28 lymph nodes
Extranodal extension identified
Margins negative

3/2020 Began 12 rounds of FolFox
9/2020 Finished FolFox
12/2020 PET Scan-NED
1-2021 CTdna test


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