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Evaluation of ct‑DNA and mutational status in liquid biopsy of patients with metastatic colorectal cancer

  • Authors:
    • George Zarkavelis
    • Melina Yerolatsite
    • Panagiotis Ntellas
    • Aikaterini Tsantikidi
    • Irene Papadopoulou
    • Nanteznta Torounidou
    • Katerina Dadouli
    • George Nasioulas
    • Eleftherios Kampletsas
    • George Pentheroudakis
  • View Affiliations / Copyright

    Affiliations: Department of Medical Oncology, University Hospital of Ioannina, 45500 Ioannina, Greece, Genekor Medical S.A., 15344 Athens, Greece, Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece
    Copyright: © Zarkavelis et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 283
    |
    Published online on: May 6, 2026
       https://doi.org/10.3892/ol.2026.15637
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Abstract

Liquid biopsy has become an increasingly important tool in clinical oncology due to the utility of circulating tumor DNA (ct‑DNA). Plasma ct‑DNA levels reflect the tumor burden of patients and provide valuable information for personalized treatment strategies. Colorectal cancer (CRC) is among the most frequently diagnosed malignancies worldwide and remains a leading cause of cancer‑related mortality. The implementation of personalized therapy can notably improve clinical outcomes in these patients. The present study aimed to evaluate ct‑DNA in patients with metastatic CRC undergoing therapy at the Department of Medical Oncology, University Hospital of Ioannina (Ioannina, Greece), using next‑generation sequencing (NGS) to identify tumor mutations in both tissue and cell‑free plasma DNA. A total of 45 patients newly diagnosed with metastatic CRC were enrolled in the current study. ct‑DNA evaluation was performed at diagnosis, and both tissue and plasma samples were analyzed using NGS to assess the mutational profile. The most frequent mutation identified was in KRAS. A high level of concordance was observed between tissue and plasma samples regarding ct‑DNA detection and mutational status. Sequential ct‑DNA analysis during therapy revealed dynamic changes in mutation profiles over the course of treatment. In conclusion, liquid biopsy offers marked clinical value as a minimally invasive tool for personalized therapy in metastatic CRC. NGS‑based liquid biopsy enables real‑time evaluation of ct‑DNA and mutation status during treatment, supporting therapeutic decision‑making and disease monitoring.
View Figures

Figure 1

Baseline KRAS MAF in both
tissue and liquid samples (P=0.022). MAF, mutant allele
fraction.

Figure 2

Mutational changes in KRAS and
NRAS during progressive disease.
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Copy and paste a formatted citation
Spandidos Publications style
Zarkavelis G, Yerolatsite M, Ntellas P, Tsantikidi A, Papadopoulou I, Torounidou N, Dadouli K, Nasioulas G, Kampletsas E, Pentheroudakis G, Pentheroudakis G, et al: Evaluation of ct‑DNA and mutational status in liquid biopsy of patients with metastatic colorectal cancer. Oncol Lett 32: 283, 2026.
APA
Zarkavelis, G., Yerolatsite, M., Ntellas, P., Tsantikidi, A., Papadopoulou, I., Torounidou, N. ... Pentheroudakis, G. (2026). Evaluation of ct‑DNA and mutational status in liquid biopsy of patients with metastatic colorectal cancer. Oncology Letters, 32, 283. https://doi.org/10.3892/ol.2026.15637
MLA
Zarkavelis, G., Yerolatsite, M., Ntellas, P., Tsantikidi, A., Papadopoulou, I., Torounidou, N., Dadouli, K., Nasioulas, G., Kampletsas, E., Pentheroudakis, G."Evaluation of ct‑DNA and mutational status in liquid biopsy of patients with metastatic colorectal cancer". Oncology Letters 32.1 (2026): 283.
Chicago
Zarkavelis, G., Yerolatsite, M., Ntellas, P., Tsantikidi, A., Papadopoulou, I., Torounidou, N., Dadouli, K., Nasioulas, G., Kampletsas, E., Pentheroudakis, G."Evaluation of ct‑DNA and mutational status in liquid biopsy of patients with metastatic colorectal cancer". Oncology Letters 32, no. 1 (2026): 283. https://doi.org/10.3892/ol.2026.15637
Copy and paste a formatted citation
x
Spandidos Publications style
Zarkavelis G, Yerolatsite M, Ntellas P, Tsantikidi A, Papadopoulou I, Torounidou N, Dadouli K, Nasioulas G, Kampletsas E, Pentheroudakis G, Pentheroudakis G, et al: Evaluation of ct‑DNA and mutational status in liquid biopsy of patients with metastatic colorectal cancer. Oncol Lett 32: 283, 2026.
APA
Zarkavelis, G., Yerolatsite, M., Ntellas, P., Tsantikidi, A., Papadopoulou, I., Torounidou, N. ... Pentheroudakis, G. (2026). Evaluation of ct‑DNA and mutational status in liquid biopsy of patients with metastatic colorectal cancer. Oncology Letters, 32, 283. https://doi.org/10.3892/ol.2026.15637
MLA
Zarkavelis, G., Yerolatsite, M., Ntellas, P., Tsantikidi, A., Papadopoulou, I., Torounidou, N., Dadouli, K., Nasioulas, G., Kampletsas, E., Pentheroudakis, G."Evaluation of ct‑DNA and mutational status in liquid biopsy of patients with metastatic colorectal cancer". Oncology Letters 32.1 (2026): 283.
Chicago
Zarkavelis, G., Yerolatsite, M., Ntellas, P., Tsantikidi, A., Papadopoulou, I., Torounidou, N., Dadouli, K., Nasioulas, G., Kampletsas, E., Pentheroudakis, G."Evaluation of ct‑DNA and mutational status in liquid biopsy of patients with metastatic colorectal cancer". Oncology Letters 32, no. 1 (2026): 283. https://doi.org/10.3892/ol.2026.15637
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