作者
Jeanne Tie, Joshua D Cohen, Kamel Lahouel, Serigne N Lo, Yuxuan Wang, Suzanne Kosmider, Rachel Wong, Jeremy Shapiro, Margaret Lee, Sam Harris, Adnan Khattak, Matthew Burge, Marion Harris, James Lynam, Louise Nott, Fiona Day, Theresa Hayes, Sue-Anne McLachlan, Belinda Lee, Janine Ptak, Natalie Silliman, Lisa Dobbyn, Maria Popoli, Ralph Hruban, Anne Marie Lennon, Nicholas Papadopoulos, Kenneth W Kinzler, Bert Vogelstein, Cristian Tomasetti, Peter Gibbs
发表日期
2022/6/16
期刊
New England Journal of Medicine
卷号
386
期号
24
页码范围
2261-2272
出版商
Massachusetts Medical Society
简介
Background
The role of adjuvant chemotherapy in stage II colon cancer continues to be debated. The presence of circulating tumor DNA (ctDNA) after surgery predicts very poor recurrence-free survival, whereas its absence predicts a low risk of recurrence. The benefit of adjuvant chemotherapy for ctDNA-positive patients is not well understood.
Methods
We conducted a trial to assess whether a ctDNA-guided approach could reduce the use of adjuvant chemotherapy without compromising recurrence risk. Patients with stage II colon cancer were randomly assigned in a 2:1 ratio to have treatment decisions guided by either ctDNA results or standard clinicopathological features. For ctDNA-guided management, a ctDNA-positive result at 4 or 7 weeks after surgery prompted oxaliplatin-based or fluoropyrimidine chemotherapy. Patients who were ctDNA-negative were not treated. The primary efficacy end point was …
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J Tie, JD Cohen, K Lahouel, SN Lo, Y Wang… - New England Journal of Medicine, 2022