Elvina Almuradova: CtDNA-guided approach for ACT in stage II colon cancer
Elvina Almuradova, Associate Professor of Oncology at the European Institute of Oncology (IEO), shared a post on LinkedIn about recent paper by Jeanne Tie et al., titled “Circulating tumor DNA analysis guiding adjuvant therapy in stage II colon cancer: 5-year outcomes of the randomized DYNAMIC trial” published on Nature Medicine.
Authors: Jeanne Tie, Yuxuan Wang, Serigne N. Lo, Kamel Lahouel, Joshua D. Cohen, Rachel Wong, Jeremy D. Shapiro, Samuel J. Harris, Adnan Khattak, Matthew E. Burge, Margaret Lee, Marion Harris, Sue-Anne McLachlan, Lisa Horvath, Christos Karapetis, Jenny Shannon, Madhu Singh, Desmond Yip, Sumitra Ananda, Craig Underhill, Janine Ptak, Natalie Silliman, Lisa Dobbyn, Maria Popoli, Peter Gibbs
“The 5-year outcomes of the DYNAMIC trial confirm that circulating tumor DNA (ctDNA)-guided adjuvant chemotherapy (ACT) in stage II colon cancer reduces chemotherapy use without compromising long-term outcomes.
Key findings:
– 5-year recurrence-free survival (RFS): 88% (ctDNA-guided) vs. 87% (standard management).
– 5-year overall survival: 93.8% vs. 93.3% (HR 1.05, P = 0.887).
– ctDNA clearance at the end of ACT: Observed in 87.5% of treated ctDNA-positive patients.
– Higher postoperative ctDNA burden linked to worse 5-year RFS (HR 10.62, P = 0.005).
– New ctDNA assay (post hoc analysis):
– Patients with ctDNA clearance: 97% 5-year RFS.
– Patients with ctDNA persistence: 0% 5-year RFS (*P* < 0.001).
These findings validate a ctDNA-guided approach for ACT in stage II colon cancer, with potential for further risk stratification based on ctDNA burden and end-of-treatment results.”
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