A Positive Tumor-informed assay like signatera is not just a prognostic or predictive marker, but more so signifies PERSISTENCE of disease. A stage-2 average risk is not average risk anymore once you have a positive ctDNA result. Maybe in the future, the TNM would be revised to say TNM-MRD (Sta...

I respectfully disagree on this issue with my colleague, Dr. @Kasi. I do not draw, nor recommend, ctDNA in stage II or III colon cancer patients outside of a clinical trial. I would not give a favorable risk stage II patient chemo based on such a test. Dr. Kasi has cited the study by Dr. Tie et al.,...

I strongly would recommend adjuvant chemotherapy in the stage II colon patient with positive postoperative ctDNA. In my discussion with other GI oncologists, most agree with this position. I feel that there is sufficient data to support this plan. The main dilemma is the situation where ctDNA is pos...

I thoroughly support the use of ctDNA in adjuvant tx decisions for Stage II colon cancer.Stage II colon cancer identification as “favorable” or “ unfavorable” based on path and clinical risk factors may increase expected relapse risk from standard 15% up to perhaps 30%. This ...

Post-surgical ctDNA has been studied as a marker for increased risk of recurrence in stage I-III colon cancer in several studies. In one prospective, multicenter study of 130 patients with stage I-III colon cancer, ctDNA detected 30 days after surgery was seven times more likely to be associated wit...