, Dans notre étude, entre C1 et C2, le taux d'ACE a augmenté chez 21/53 (39,6 %) patients, parmi eux 17/21 (81 %) n'ont pas présenté de progression radiologique à M3. Entre C1 et C3, le taux d'ACE a augmenté chez 17/50 (34 %) patients, parmi eux 15/17 (88,2 %) n'ont pas présenté de progression radiologique à M3. Ces données confirment les observations menées par Sorbye et coll. qui avaient décrit un « flare up, p.0
, CONCLUSION Nos résultats issus de l'analyse préliminaire de l'étude prospective COCA-MACS confirment la valeur pronostique des taux initiaux d'ADN total et d'ADN tumoral circulant dans le cancer colorectal métastatique
, Nous montrons une association significative entre la variation précoce de l'ADN
, 2 cures de chimiothérapie ainsi que sa cinétique calculée entre l'inclusion et la 2 ème cure de chimiothérapie et la survie sans progression. Nos résultats offrent la perspective d'un monitoring précoce de l'ADN tumoral circulant, permettant de préciser le pronostic à long terme et d'adapter de manière précoce la stratégie thérapeutique en première ligne de chimiothérapie
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