Multifocal Clonal Evolution Characterized Using Circulating Tumor DNA Compared with Tumor Biopsies in Metastatic Colorectal Cancer by Targeted Next Generation Sequencing

摘要

OBJECTIVE: Intratumor clonal heterogeneity limits efficacy and duration of response to targeted treatments in metastatic cancer. About 50% of colorectal cancer patients have such distant metastases, accounting for virtually all deaths from the disease. We followed a patient with metastatic colon carcinoma who had undergone several surgeries after being diagnosed with colorectal cancer in 2006 and had survived for over 10 years.