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ctDNA-based molecular residual disease and survival in resectable colorectal cancer
- Source :
- Nature Medicine; 20240101, Issue: Preprints p1-12, 12p
- Publication Year :
- 2024
-
Abstract
- The interim analysis of the CIRCULATE-Japan GALAXY observational study demonstrated the association of circulating tumor DNA (ctDNA)-based molecular residual disease (MRD) detection with recurrence risk and benefit from adjuvant chemotherapy (ACT) in resectable colorectal cancer (CRC). This updated analysis with a 23-month median follow-up, including 2,240 patients with stage II–III colon cancer or stage IV CRC, reinforces the prognostic value of ctDNA positivity during the MRD window with significantly inferior disease-free survival (DFS; hazard ratio (HR): 11.99, P< 0.0001) and overall survival (OS; HR: 9.68, P< 0.0001). In patients who experienced recurrence, ctDNA positivity correlated with shorter OS (HR: 2.71, P< 0.0001). The significantly shorter DFS in MRD-positive patients was consistent across actionable biomarker subsets. Sustained ctDNA clearance in response to ACT was an indicator of favorable DFS and OS compared to transient clearance (24-month DFS: 89.0% versus 3.3%; 24-month OS: 100.0% versus 82.3%). True spontaneous clearance rate with no clinical recurrence was 1.9% (2/105). Overall, our findings provide evidence for the utility of ctDNA monitoring for post-resection recurrence and mortality risk stratification that could be used for guiding adjuvant therapy.
Details
- Language :
- English
- ISSN :
- 10788956 and 1546170X
- Issue :
- Preprints
- Database :
- Supplemental Index
- Journal :
- Nature Medicine
- Publication Type :
- Periodical
- Accession number :
- ejs67413930
- Full Text :
- https://doi.org/10.1038/s41591-024-03254-6