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In 1,039 Japanese patients, tumour DNA in blood four weeks after surgery was the strongest predictor of recurrence ever measured in this disease, and picked out exactly the patients whose chemotherapy did some good.
Kotani, Oki, Nakamura and colleagues report results from GALAXY, the observational arm of the ongoing CIRCULATE-Japan study, which analysed presurgical and postsurgical circulating tumour DNA in 1,039 patients with stage II to IV resectable colorectal cancer, with a median follow-up of 16.74 months.
The study is the largest prospective analysis of circulating tumour DNA in resectable colorectal cancer and supports using the test both to identify patients at increased risk of recurrence and to identify those likely to benefit from adjuvant chemotherapy.
The predictive half of the ctDNA case: chemotherapy after surgery helps the patients whose blood test is positive and appears to do little for those whose test is negative, which is the rationale for the randomised CIRCULATE trials now running in Japan, the United States and Europe.
Shares Circulating tumor DNA analysis guiding adjuvant therapy in stage II colon cancer (DYNAMIC), Take ctDNA-guided de-escalation beyond stage II, and stop escalating on a positive result until a trial says it helps, Signatera, Dormant cells and minimal residual disease and the tag colorectal-evidence.
Shares Takayuki Yoshino, Take ctDNA-guided de-escalation beyond stage II, and stop escalating on a positive result until a trial says it helps, Colorectal cancer roadmap: from the adenoma-carcinoma sequence and the first screening trials to total mesorectal excision, oxaliplatin, RAS testing, immunotherapy for mismatch repair-deficient disease, ctDNA-guided treatment and organ preservation, Colon cancer (adenocarcinoma of the colon) and the tag colorectal-evidence.
Shares Minimal / molecular residual disease (MRD), Circulating tumour DNA (ctDNA), Colorectal cancer roadmap: from the adenoma-carcinoma sequence and the first screening trials to total mesorectal excision, oxaliplatin, RAS testing, immunotherapy for mismatch repair-deficient disease, ctDNA-guided treatment and organ preservation, MRD / molecular residual disease testing and the tag colorectal-evidence.
Shares Circulating tumor DNA analysis guiding adjuvant therapy in stage II colon cancer (DYNAMIC), Colorectal cancer roadmap: from the adenoma-carcinoma sequence and the first screening trials to total mesorectal excision, oxaliplatin, RAS testing, immunotherapy for mismatch repair-deficient disease, ctDNA-guided treatment and organ preservation, Colon cancer (adenocarcinoma of the colon), Colorectal cancer and the tag colorectal-evidence.
Shares Takayuki Yoshino, Colorectal cancer roadmap: from the adenoma-carcinoma sequence and the first screening trials to total mesorectal excision, oxaliplatin, RAS testing, immunotherapy for mismatch repair-deficient disease, ctDNA-guided treatment and organ preservation, Colorectal cancer and the tag colorectal-evidence.
Shares Takayuki Yoshino, Colorectal cancer roadmap: from the adenoma-carcinoma sequence and the first screening trials to total mesorectal excision, oxaliplatin, RAS testing, immunotherapy for mismatch repair-deficient disease, ctDNA-guided treatment and organ preservation, Colorectal cancer and the tag colorectal-evidence.
Shares Takayuki Yoshino, Colorectal cancer roadmap: from the adenoma-carcinoma sequence and the first screening trials to total mesorectal excision, oxaliplatin, RAS testing, immunotherapy for mismatch repair-deficient disease, ctDNA-guided treatment and organ preservation, Colorectal cancer and the tag colorectal-evidence.
Shares Takayuki Yoshino, Colorectal cancer roadmap: from the adenoma-carcinoma sequence and the first screening trials to total mesorectal excision, oxaliplatin, RAS testing, immunotherapy for mismatch repair-deficient disease, ctDNA-guided treatment and organ preservation, Colorectal cancer and the tag colorectal-evidence.