Key clinical point: Use of circulating tumor DNA (ctDNA)-guided approach for treating stage II colon cancer decreases the use of adjuvant chemotherapy without altering the risk for recurrence.
Major finding: After a median follow-up of 37 months, patients receiving ctDNA-guided vs standard management had a lower adjuvant chemotherapy rate (15% vs 28%; relative risk 1.82; 95% CI 1.25-2.65) and a similar 2-year recurrence-free survival rate (93.5% vs 92.4%; absolute difference, 1.1 percentage points; 95% CI −4.1 to 6.2 [noninferiority margin −8.5 percentage points]).
Study details: The data come from a multicenter phase 2 trial, DYNAMIC, involving 455 patients with resected stage II colon cancer who were assigned to ctDNA-guided (n = 302) or standard (n = 153) management.
Disclosures: This study was sponsored by the Australian National Health and Medical Research Council and other sources. The authors declared no conflicts of interest.
Source: Tie J et al for the DYNAMIC Investigators. Circulating tumor DNA analysis guiding adjuvant therapy in stage II colon cancer. N Engl J Med. 2022;386:2261-2272 (Jun 16). Doi: 10.1056/NEJMoa2200075