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May 29, 2026Journal of Clinical Oncology

Real-world outcomes and circulating tumor DNA (ctDNA) dynamics in patients (pts) with microsatellite instability–high (MSI-H) metastatic colorectal cancer (CRC) treated with immune checkpoint inhibitors (ICI).

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Authors

HRHannah R. RobinsonNHNicholas J. HornsteinPBPatrick M. Boland

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Overview

Randomized trial evaluates ctDNA dynamics correlated with outcomes in MSI-H metastatic colorectal cancer, implying potential for better treatment strategies.

Key Points

  • This research aims to understand how ctDNA dynamics relate to treatment outcomes in patients with MSI-H metastatic colorectal cancer receiving immune checkpoint inhibitors.
  • Identified patients with MSI-H mCRC treated with first-line ICIs from Natera’s Real-World Database, linking ctDNA results and claims data.
  • Estimated overall survival using mortality data and assessed ctDNA status before and after ICI treatment.
  • Evaluated time to next treatment and ctDNA levels post-ICI initiation.
  • Among 559 patients, 71.7% were ctDNA-positive before treatment; 81.0% achieved ctDNA clearance after ICI.
  • ctDNA positivity at any point after ICI initiation predicted inferior OS (HR: 4.9, p < 0.001).
  • Those with ctDNA-negative tests post-ICI had longer treatment duration (median 303 days) compared to ctDNA-positive (median 192 days).

Cite This Study

Robinson et al. (2026) studied this question.

synapsesocial.com/papers/6a192e4efab5b468c44174a1https://doi.org/10.1200/jco.2026.44.16_suppl.3516
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