Rishabh Jain, Medical Oncologist at AIIMS, shared a post on X:
“ctDNA-positive CRC after curative surgery sounds like the perfect place to intervene.
But ALTAIR says: not so fast.
- Phase 3, double-blind trial
- Resected stage 0-IV CRC
- ctDNA-positive, radiology-negative
- FTD/TPI vs placebo
Key result
- Median DFS: 9.3 vs 5.6 months
- HR 0.79 (95% CI 0.60-1.05)
- p=0.107
Primary endpoint: negative.
Signal?
- Stage IV subgroup looked better:
- HR 0.53
- p=0.012
But exploratory only.
- Toxicity mattered
- Grade ≥3 AEs: 73% vs 3.3%
- Grade ≥3 neutropenia: 56.6%
My takeaway
ctDNA remains an outstanding prognostic biomarker.
But acting on molecular recurrence does not automatically translate into meaningful clinical benefit.
ALTAIR is an important reminder that MRD detection ≠ MRD eradication.
Save this trial. You’ll be quoting it in every ctDNA discussion over the next year.”
Title: Post-adjuvant chemotherapy in ctDNA-positive patients with resected colorectal cancer: a randomized phase 3 trial
Authors: Hideaki Bando, Jun Watanabe, Yusuke Takahashi, Masahito Kotaka, Nobuhisa Matsuhashi, Eiji Oki, Yoshito Komatsu, Manabu Shiozawa, Keiji Hirata, Yuji Miyamoto, Masanobu Takahashi, Kentaro Yamazaki, Dai Manaka, Akiyoshi Kanazawa, Yi-Hsin Liang, Kun-Huei Yeh, Yuko Watsuji, Yuko Yamamoto, Makoto Fukui, Shruti Sharma, Vasily Aushev, Adham Jurdi, Matthew Rabinowitz, Minetta Liu, Takeshi Kato
Read the Full Article.
Other articles featuring Rishabh Jain on OncoDaily.