Although the clinical application of circulating tumor DNA (ctDNA) in guiding therapeutic decisions is still developing, it is already an established marker of minimal residual disease (MRD) in colorectal cancer (CRC). Clinical studies are increasingly investigating ctDNA’s utility in guiding treatment decisions for various gastrointestinal cancers.

The BESPOKE CRC trial evaluated ctDNA-based MRD to inform adjuvant chemotherapy decisions for stage II/III patients with CRC. The study analyzed plasma samples from 350 patients and found that ctDNA positivity was linked to a significantly higher risk of recurrence. In the phase 2 AGITG DYNAMIC-Rectal trial, researchers examined ctDNA’s role in guiding adjuvant chemotherapy in locally advanced rectal cancer. They found that ctDNA-guided management reduced the rate of chemotherapy administration compared to standard management. These studies underscore ctDNA’s prognostic and predictive value, suggesting it should be integrated into clinical decision-making for better monitoring and treatment effectiveness.

Reference: Piljac Žegarac J. Studies Confirm the Utility of ctDNA in Guiding Adjuvant Chemotherapy in CRC. ASCO Daily News. Published January 20, 2024. Accessed July 12, 2024. https://dailynews.ascopubs.org/do/studies-confirm-utility-ctdna-guiding-adjuvant-chemotherapy-crc?cid=DM16116&bid=339678085