Authors' results and conclusions: Circulating tumour DNA (ctDNA) assays have the potential to interrogate the cancer genome for specific, pre-selected or unselected abnormalities. This information may then be used for screening, diagnosis, prognosis, in addition to the prediction and monitoring of, the response to therapy. The ability to readily monitor tumour burden and chemo sensitivity has the potential to dramatically alter current clinical practice, in that subclinical responses may be identified early in treatment and chemotherapy adjusted before patients develop an overt relapse. The major advantage of ctDNA assays is that they require a blood sample rather than biopsy sampling using invasive techniques. This is of particular importance for patients in whom biopsy of the primary lesion is impractical or not possible. However, the major disadvantage at this time lies in clarifying the validity of these assays, and their clinical utility when compared with the large extent evidence regarding invasive techniques.

Authors' recommendations: HealthPACT noted that although the sensitivity of this technique is low, it has the potential to reduce the number of invasive biopsies performed, with only patients who test negative needing to undergo biopsy. HealthPACT also noted that circulating tumour DNA assays have the potential to shorten the time from presentation to diagnosis. It is unlikely at this point in time that this technology would be cost-effective once the cost of the technique is taken into account. However, this technology in the future may lead to significant cost-savings and greater patient acceptance as the need to undergo imaging and other diagnostic tests may be reduced. HealthPACT does not support investment in this technology in clinical practice at this time; however it is recommended that the evidence be reviewed again in 24 months.

Project Status: Completed

Year Published: 2015

URL for published report: Not Available

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Australia

Organisation Name: Adelaide Health Technology Assessment

Contact Address: School of Public Health, Mail Drop 545, University of Adelaide, Adelaide SA 5005, AUSTRALIA, Tel: +61 8 8313 4617

Contact Name: ahta@adelaide.edu.au

Contact Email: ahta@adelaide.edu.au

Copyright: Adelaide Health Technology Assessment (AHTA)