Would you withhold adjuvant FOLFOX in stage III colon cancer if Signatera circulating tumor DNA testing is negative?

No, not yet. GALAXY data (Kotani et al., PMID 36646802) suggest that adjuvant chemo does not benefit the ctDNA neg population, but the median follow-up is 16.74 months. If the longer-term data shows the same, you can make a case for de-escalation. For now, I would offer adjuvant FOLFOX to all resect...

I agree with Dr. @Dr. First Last completely that this is not the current standard of care, but is an area of active clinical investigation. In the United States, the CIRCULATE-US trial is looking at randomization to standard of care chemotherapy for low risk stage III colon cancer patients versus mo...

CtDNA use is picking up dramatically 'outside of clinical trials' and is reimbursed in most scenarios. The data while still maturing, is still strong in the different settings (prognostic for recurrence, and recently, conversion from positive to negative is also correlated with better outcomes).

In ...