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Retrospective patient series indicate that a positive test for circulating tumor DNA (ctDNA) after surgery for stage II colon cancer is highly predictive of early disease recurrence, and a negative test correlates with low risk for recurrence. Patient selection for adjuvant therapy based on ctDNA testing is the subject of ongoing clinical trials.
In the current trial, patients with resected stage II colon cancer were randomized 2:1 to treatment with adjuvant chemotherapy based on either standard high risk pathologic criteria or ctDNA results on tests performed 4 and 7 weeks after surgery. Patients with positive ctDNA results received clinician's choice of single-agent fluoropyrimidine or oxaliplatin-based chemotherapy; those with negative re…