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This research examines how circulating tumor DNA (ctDNA) can guide treatment decisions after surgery for colorectal cancer.

July 28, 2026BiomedicinesOpen Access

Circulating Tumor DNA-Guided Adjuvant and Post-Adjuvant Therapy in Resected Colorectal Cancer: From Molecular Residual Disease Detection to Proven Clinical Utility

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This research examines how circulating tumor DNA (ctDNA) can guide treatment decisions after surgery for colorectal cancer.
Reviewed recent randomized clinical trials including DYNAMIC-III and ALTAIR.
Evaluated ctDNA levels for treatment management in stage II and III colorectal cancer patients.
Analyzed outcomes based on ctDNA status to inform chemotherapy intensity.
DYNAMIC trial reduced adjuvant chemotherapy use from 27.9% to 15.3% in stage II colon cancer with similar recurrence-free survival (88% vs. 87%; 95% CI 5.8% to 8.0%).
ctDNA identified as a critical prognostic biomarker, with a hazard ratio of 11.99 for disease-free survival.
Escalating chemotherapy for ctDNA-positive stage III patients showed no improvement in recurrence-free survival (HR 1.11, p = 0.6).

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Randomized trial investigates ctDNA-guided therapy impacting recurrence outcomes in colorectal cancer, suggesting better treatment choices.

Koo et al. (2026) studied this question.

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Randomized trial investigates ctDNA-guided therapy impacting recurrence outcomes in colorectal cancer, suggesting better treatment choices.