{"entity":{"id":"circulate-us","kind":"trial","name":"CIRCULATE-US","aka":["NRG-GI008","Colon Adjuvant Chemotherapy Based on Evaluation of Residual Disease"],"tldr":"The US national trial that uses a blood test for leftover tumour DNA to decide who gets less chemotherapy and who gets more after stage III colon cancer surgery, with both questions randomised.","summary":"CIRCULATE-US (NRG-GI008) is the NRG Oncology phase 2/3 trial in resected stage III colon cancer. Patients are tested with Signatera after surgery; ctDNA-negative patients are randomised between immediate chemotherapy and surveillance with treatment on conversion, and ctDNA-positive patients are randomised between standard mFOLFOX6 or CAPOX and intensified mFOLFIRINOX. The registry lists an estimated 1,912 participants, a start on 8 July 2022, recruiting status, primary completion on 10 March 2029 and study completion on 10 March 2030. It is the US counterpart of CIRCULATE-Japan and TRACC and the trial most likely to settle whether escalation helps ctDNA-positive colon cancer.","status":"recruiting","asOf":"2026-09-21","links":[{"label":"ClinicalTrials.gov NCT05174169","url":"https://clinicaltrials.gov/study/NCT05174169"}],"tags":["ctdna-roadmap"],"related":["dynamic","circulate-japan","tracc","ctdna-mrd-to-adjuvant","ctdna-tests"],"cancers":["colorectal"],"sections":[],"technologies":["mrd-testing","liquid-biopsy"],"targets":[],"drugs":["signatera","capox"],"companies":["nrg-oncology","natera"],"institutions":[],"pathways":[],"terms":["mrd","ctdna","de-escalation","tumour-informed-assay"],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"nct":"NCT05174169","phase":"2/3","setting":"Resected stage III colon cancer in the United States: Signatera result assigns patients to randomised de-escalation (shorter or later chemotherapy) if negative or escalation (mFOLFIRINOX against mFOLFOX6 or CAPOX) if positive","sponsor":"NRG Oncology","enrolled":1912,"enrolledBasis":"registry","outcomes":[]},"route":"/trials/circulate-us/","neighbours":{"trial":[{"id":"bespoke-crc","kind":"trial","name":"BESPOKE CRC","route":"/trials/bespoke-crc/"},{"id":"circulate-japan","kind":"trial","name":"CIRCULATE-Japan (GALAXY / VEGA / ALTAIR)","route":"/trials/circulate-japan/"},{"id":"dynamic","kind":"trial","name":"DYNAMIC","route":"/trials/dynamic/"},{"id":"tracc","kind":"trial","name":"TRACC","route":"/trials/tracc/"}],"pairing":[{"id":"ctdna-mrd-to-adjuvant","kind":"pairing","name":"ctDNA MRD → adjuvant therapy decision","route":"/pairings/ctdna-mrd-to-adjuvant/"}],"roadmap":[{"id":"ctdna-tests","kind":"roadmap","name":"ctDNA tests roadmap: from a curiosity in plasma to blood tests that decide treatment","route":"/roadmaps/ctdna-tests/"}],"cancer":[{"id":"colorectal","kind":"cancer","name":"Colorectal cancer","route":"/cancers/colorectal/"}],"technology":[{"id":"liquid-biopsy","kind":"technology","name":"Liquid biopsy (ctDNA)","route":"/technologies/liquid-biopsy/"},{"id":"mrd-testing","kind":"technology","name":"MRD / molecular residual disease testing","route":"/technologies/mrd-testing/"}],"drug":[{"id":"capox","kind":"drug","name":"CAPOX (capecitabine, oxaliplatin)","route":"/drugs/capox/"},{"id":"signatera","kind":"drug","name":"Signatera","route":"/drugs/signatera/"}],"institution":[{"id":"nrg-oncology","kind":"institution","name":"NRG Oncology","route":"/institutions/nrg-oncology/"}],"company":[{"id":"natera","kind":"company","name":"Natera","route":"/companies/natera/"}],"term":[{"id":"ctdna","kind":"term","name":"Circulating tumour DNA (ctDNA)","route":"/terms/ctdna/"},{"id":"de-escalation","kind":"term","name":"De-escalation, escalation and response-adapted therapy","route":"/terms/de-escalation/"},{"id":"mrd","kind":"term","name":"Minimal / molecular residual disease (MRD)","route":"/terms/mrd/"},{"id":"tumour-informed-assay","kind":"term","name":"Tumour-informed versus tumour-naive ctDNA assays","route":"/terms/tumour-informed-assay/"}]}}