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The first trial to let a blood test alone enrol people into a targeted treatment, and to show it selects as well as a tumour biopsy does.
TRIUMPH, run inside Japan's SCRUM-Japan screening platform, tested pertuzumab with trastuzumab in metastatic colorectal cancer whose HER2 amplification was confirmed prospectively either in tumour tissue or in circulating tumour DNA. Thirty patients were treated. The study met its primary endpoint with a confirmed objective response rate of 30 percent in the 27 tissue-positive patients and 28 percent in the 25 ctDNA-positive patients, against 0 percent in a matched real-world reference population on standard salvage therapy. Baseline ctDNA genotyping of HER2 copy number and concurrent oncogenic alterations, adjusted for tumour fraction, stratified patients for benefit about as well as tissue genotyping did, and a fall in ctDNA fraction at three weeks tracked response. A 2026 analysis of 66 enrolled patients found that previous anti-EGFR therapy (median overall survival 10.9 against 19.7 months) and resistance alterations detected in baseline ctDNA (no responses, median overall survival 7.6 against 16.5 months) both predict failure. TRIUMPH is the proof that liquid biopsy can be the entry criterion for a trial, not just a description of it.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
30 treated.
| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Confirmed objective response rateprimary | Tissue HER2-positive | 27 | 30 percent | - | - | link |
| ctDNA HER2-positive | 25 | 28 percent |
Shares MOUNTAINEER, HER2-amplified colorectal cancer, Trastuzumab, HER2.
Shares HER2-amplified colorectal cancer, Trastuzumab, Monoclonal antibodies, Colorectal cancer.
Shares MyPathway, Pertuzumab, Trastuzumab, HER2.
Shares MOUNTAINEER, HER2-amplified colorectal cancer, Trastuzumab, HER2.
Shares HERACLES, HER2-amplified colorectal cancer, Trastuzumab.
Shares Pertuzumab, Circulating tumour DNA (ctDNA), Trastuzumab, HER2.
Shares Pertuzumab, Trastuzumab, Monoclonal antibodies.
Shares MOUNTAINEER, HER2-amplified colorectal cancer, Trastuzumab, HER2.