Background: Increasing evidence shows that circulating tumor DNA (ctDNA) is a valuable tool in providing molecular, prognostic, predictive and dynamic information in colorectal cancer (CRC) patients. This study aimed to make a picture of knowledge, practice, attitudes and expectations about ctDNA in CRC patients. Material and methods: An online CRC-ctdna survey was distributed from November 2019 to January 2020 to French and Italian cooperative and scientific groups of Hepato-Gastroenterologists (HGE), Medical Oncologists (MO), Radiotherapists (RT) and Digestive Surgeons (DS). Results: Overall, 307 physicians completed the survey (57 Italian; 43 French). Most of them were MO (62) and HGE (24). Affiliations were University Hospital (48), Cancer Center (21), General Hospital (21) and Private Hospital (10). Notably, half of respondents declared to have access to ctDNA in their daily practice. Of them, 53 uses ctDNA to assess RAS/BRAF status only, 46 for RAS/BRAF with other mutations and 1only for other mutations. MO and HGE identified quick RAS profiling (P = 0.031) as the main reason of interest in the use of ctDNA. Physicians from University Hospitals and Cancer Centers prescribed more ctDNA (P< 0.001) and more often in house (P<0.001). The main future expectations concerning ctDNA were to guide therapeutic strategies in metastatic (78) and adjuvant (73) settings, and to better/quicker profile disease at baseline (56). Conclusion: Half of participants can order ctDNA in their daily practice. Molecular profiling of metastatic patients remains the main goal of ctDNA use and ctDNA-based therapeutic strategies are an expectation for the future in both adjuvant and metastatic settings.
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