Circulating Tumor DNA Status and Adjuvant Chemotherapy in Resected Colorectal Liver Metastases - Summary - MDSpire
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Status of Circulating Tumor DNA and Its Impact on Adjuvant Chemotherapy Following Resection of Colorectal Liver Metastases

  • By

  • Kozo Kataoka

  • Kazuma Ito

  • Yoshiaki Nakamura

  • Jun Watanabe

  • Naoya Akazawa

  • Jun Nagata

  • Mitsuru Yokota

  • Kentaro Kato

  • Masahito Kotaka

  • Tadayoshi Hashimoto

  • Kentaro Yamazaki

  • Yoshinori Kagawa

  • Saori Mishima

  • Koji Ando

  • Masaaki Miyo

  • Hiroki Yukami

  • Arkarachai Fungtammasan

  • Shruti Sharma

  • J. Bryce Ortiz

  • Matthew Rabinowitz

  • Robert W. Lentz

  • Adham Jurdi

  • Minetta C. Liu

  • Alexey Aleshin

  • Daisuke Kotani

  • Hideaki Bando

  • Hiroya Taniguchi

  • Ichiro Takemasa

  • Takeshi Kato

  • Takayuki Yoshino

  • Eiji Oki

  • CIRCULATE-Japan Group

  • Kei Kimura

  • Ikuo Matsuda

  • Masataka Ikeda

  • Yuko Fukumoto

  • Satoshi Kobayashi

  • Hiroki Sokuoka

  • September 1, 2026

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Objective:

To assess the prognostic significance of circulating tumor DNA (ctDNA) and the relationship between adjuvant chemotherapy (ACT) and overall survival (OS) stratified by molecular residual disease (MRD) status among patients with colorectal liver metastases (CRLM).

Approach:
  • Study Design: Retrospective subset analysis of patients with resected CRLM from the CIRCULATE-Japan GALAXY study, evaluating ctDNA status and its association with ACT and survival outcomes.
  • Patient Cohorts: Participants were divided into two cohorts: those who underwent upfront surgery and those who received neoadjuvant chemotherapy (NAC).
  • ctDNA Detection Method: A personalized, tumor-informed multiplex PCR-based next-generation sequencing assay (Signatera) was used to detect ctDNA and define MRD status.
  • Statistical Analysis: Survival outcomes were analyzed using Kaplan-Meier methods and Cox proportional hazards models, with adjustments for clinical covariates.
Key Findings:
  • Among 298 patients analyzed, 191 underwent upfront surgery and 107 received NAC.
  • The NAC cohort had more patients with multiple liver metastases and larger tumors compared to the upfront surgery cohort.
  • ctDNA positivity post-surgery was associated with higher recurrence risk and poorer survival outcomes.
Interpretation:

The findings suggest that ctDNA status is a critical biomarker for assessing the risk of recurrence in patients with CRLM following surgical resection. The presence of ctDNA post-surgery indicates a higher likelihood of residual disease, which may influence the decision to administer ACT. Furthermore, the differences in tumor characteristics between the upfront surgery and NAC cohorts highlight the need for tailored treatment strategies based on individual patient profiles.

Limitations:
  • The study excluded patients with extrahepatic metastases and those participating in interventional trials.
  • The analysis was retrospective and may be subject to biases inherent in such studies.
Conclusion:

In conclusion, ctDNA serves as a valuable prognostic tool in the management of patients with colorectal liver metastases. Its association with recurrence risk underscores the potential for ctDNA to guide adjuvant chemotherapy decisions, ultimately aiming to improve overall survival outcomes in this patient population. Further prospective studies are warranted to validate these findings and explore the clinical implications of ctDNA monitoring in routine practice.

Original Source(s)

Circulating Tumor DNA Status and Adjuvant Chemotherapy in Resected Colorectal Liver Metastases

  • by Kozo Kataoka, Kazuma Ito, Yoshiaki Nakamura, Jun Watanabe, Naoya Akazawa, Jun Nagata, Mitsuru Yokota, Kentaro Kato, Masahito Kotaka, Tadayoshi Hashimoto, Kentaro Yamazaki, Yoshinori Kagawa, Saori Mishima, Koji Ando, Masaaki Miyo, Hiroki Yukami, Arkarachai Fungtammasan, Shruti Sharma, J. Bryce Ortiz, Matthew Rabinowitz, Robert W. Lentz, Adham Jurdi, Minetta C. Liu, Alexey Aleshin, Daisuke Kotani, Hideaki Bando, Hiroya Taniguchi, Ichiro Takemasa, Takeshi Kato, Takayuki Yoshino, Eiji Oki, CIRCULATE-Japan Group, Kei Kimura, Ikuo Matsuda, Masataka Ikeda, Yuko Fukumoto, Satoshi Kobayashi, Hiroki Sokuoka

  • September 1, 2026

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