ctDNA in the Management of Resectable & Advanced Colorectal Cancer: Current Status and Future Directions
- Study type
- Review article
- Design
- Structured narrative review
- Sample size
- Not applicable (narrative review; the number of patients is not given in the abstract)
- Source
- OTT · 2026
In plain words
A ctDNA test looks for tiny pieces of tumour DNA in the blood and can show how likely the cancer is to come back after surgery for bowel (colorectal) cancer. But it has not yet been proven that deciding about chemotherapy based only on this test helps every patient. In some cases (for example stage II colon cancer) the test was able to reduce the use of chemotherapy, but in stage III and in treating molecular relapse the results were not positive. For now this test does not replace routine follow-up; discuss its use with your doctor.
Key results
Study population
This review covers stage I to III colorectal cancer and selected patients with oligometastatic stage IV disease whose disease has been resected or ablated.
Endpoints
This paper is a review and has no primary endpoint. Topics covered: the prognostic value of ctDNA in detecting molecular residual disease (MRD) after curative-intent treatment, its clinical utility in guiding therapy, and the results of the DYNAMIC, DYNAMIC-III and ALTAIR trials.
Safety and side effects
No data on adverse events are reported in the abstract.
Clinical significance and place in guidelines
Based on this review, ctDNA is useful for prognosis, counselling and assessing trial eligibility, but it should not routinely replace standard surveillance or, outside evidence-based indications and clinical trials, determine treatment escalation or de-escalation on its own. Its exact status in clinical guidelines (such as NCCN and ESMO) and regulatory approvals should be checked separately, as it is not given in the abstract.
Limitations
This paper is a narrative review and summarises the evidence descriptively rather than by quantitative analysis. The abstract does not give figures such as effect sizes or numbers of patients. According to the authors, future progress requires harmonised assays, randomised proof of outcome benefit and prospective validation of integrated risk models.
This summary was prepared by the editorial team from the published paper; the original paper is the final reference. Read the original abstract on PubMed.