For folks recognized with stage 3 colon most cancers, one of the urgent questions after surgical procedure is whether or not the most cancers is really gone, and whether or not further therapy is important. New findings from the biggest printed examine of molecular residual illness (MRD) testing counsel {that a} easy blood take a look at could supply clearer solutions than conventional staging alone, based on a information launch from Guardant Well being, Inc.
Information printed in The Journal of Scientific Oncology present {that a} circulating tumor DNA (ctDNA) blood take a look at, Guardant Reveal, extra precisely identifies sufferers at excessive danger of most cancers recurrence after surgical procedure than normal strategies used right now. The examine helps the routine use of ctDNA testing to information therapy and monitoring choices for sufferers with stage 3 colon most cancers following surgical procedure.
Researchers discovered that sufferers with detectable most cancers DNA of their blood after surgical procedure have been considerably extra more likely to expertise recurrence and had worse survival outcomes, even when conventional staging urged a decrease danger.
ctDNA blood take a look at identifies sufferers at increased danger of colon most cancers recurrence
The part 3 examine included greater than 2,000 sufferers with stage 3 colon most cancers who had undergone surgical procedure and had blood samples collected earlier than beginning adjuvant chemotherapy. Roughly 20% of sufferers nonetheless had detectable ctDNA of their blood following surgical procedure, indicating the presence of microscopic most cancers cells that imaging and pathology checks couldn’t detect.
Sufferers with detectable ctDNA confronted a four- to six-fold increased danger of most cancers recurrence or dying in contrast with these whose blood checks have been ctDNA-negative. Notably, even sufferers with smaller tumors or fewer affected lymph nodes — options usually related to higher outcomes — had greater than a six-fold increased danger of recurrence if ctDNA was current.
Researchers additionally discovered that measuring the quantity of ctDNA, often called tumor fraction, offered further perception. Sufferers with increased tumor fractions have been extra more likely to expertise early recurrence and worse survival outcomes, suggesting that ctDNA ranges could additional refine danger evaluation past a easy optimistic or unfavourable consequence.
These findings spotlight how ctDNA testing could assist determine sufferers who may gain advantage from nearer monitoring, various therapy methods, or scientific trials.
Why conventional staging has limitations
Stage 3 colon most cancers is often outlined by tumor measurement and whether or not most cancers has unfold to close by lymph nodes. After surgical procedure, many sufferers obtain adjuvant chemotherapy to cut back the chance of recurrence. Nonetheless, conventional staging doesn’t at all times precisely predict which sufferers will profit most from further therapy.
Some sufferers with higher-stage options by no means expertise recurrence, whereas others with seemingly favorable illness do. This uncertainty can result in overtreatment for some sufferers and missed alternatives for earlier intervention in others.
Circulating tumor DNA testing presents a special strategy by detecting fragments of most cancers DNA shed into the bloodstream. The presence of ctDNA after surgical procedure means that most cancers cells stay within the physique, even when scans seem clear. This idea, often called molecular residual illness, has emerged as a robust predictor of outcomes throughout a number of most cancers varieties.
How the examine was carried out
The examine was carried out by researchers from Mayo Clinic in collaboration with Guardant Well being and the Alliance for Scientific Trials in Oncology. Blood samples have been analyzed utilizing the Guardant Reveal take a look at, a tissue-free ctDNA assay designed to detect most cancers DNA with out requiring tumor tissue for comparability.
Researchers evaluated whether or not ctDNA detection after surgical procedure was related to recurrence danger and general survival, evaluating outcomes with normal tumor-node-metastasis (TNM) staging. Outcomes have been tracked over time to evaluate how nicely ctDNA predicted illness development.
By enrolling greater than 2,000 sufferers, the examine represents the biggest analysis of ctDNA-based MRD testing in stage 3 colon most cancers up to now, strengthening confidence within the findings.
All contributors had resected stage 3 colon most cancers and offered blood samples after surgical procedure however earlier than beginning chemotherapy. The massive and various affected person inhabitants allowed researchers to look at outcomes throughout a variety of tumor sizes, lymph node involvement, and scientific danger profiles.
Importantly, ctDNA testing recognized high-risk sufferers even amongst these historically thought of decrease danger primarily based on pathology alone. This implies that ctDNA testing might play a priceless position in personalizing postoperative care.
Extra findings and what this implies for sufferers
Specialists concerned within the examine emphasised that ctDNA testing could assist reply one of the frequent affected person questions after surgical procedure: Am I actually cancer-free?
“The info counsel that not solely the presence of ctDNA, however the quantity of ctDNA, as recognized by Guardant Reveal could assist refine danger past normal TNM staging, and may very well be used to information adjuvant therapy and surveillance choices,” mentioned Dr. Frank Sinicrope, professor of oncology and drugs at Mayo Clinic and principal investigator for the examine. “ctDNA testing after surgical procedure improves the accuracy of estimating a affected person’s danger of most cancers recurrence, enabling extra tailor-made suggestions for adjuvant chemotherapy and follow-up monitoring. It additionally identifies excessive danger sufferers who’re more likely to recur regardless of normal therapy, and who could profit from various therapeutic approaches.”
“This massive examine provides to rising proof that ctDNA testing with Guardant Reveal after surgical procedure helps reply the query sufferers care about most: Am I actually cancer-free?” mentioned Dr. Craig Eagle, Guardant Well being chief medical officer. “Personalizing care after surgical procedure is important as clinicians and sufferers resolve what comes subsequent. Guardant Reveal suits simply into routine apply and offers well timed, actionable perception—serving to determine sufferers at excessive danger whereas sparing others pointless therapy and anxiousness.”
For sufferers with stage 3 colon most cancers, these findings counsel {that a} blood take a look at after surgical procedure could quickly turn into an essential instrument for guiding what comes subsequent — providing a extra personalised and exact strategy to care throughout a vital part of survivorship.
References
- “Largest Revealed Examine of Molecular Residual Illness (MRD) in Stage III Colon Most cancers Exhibits Guardant Reveal Blood Check Extra Exactly Identifies Danger of Recurrence After Surgical procedure to Help Well timed Therapy Choices,” by Guardant Well being, Inc. Information launch; Feb. 2, 2026.
Editor’s word: This text is for informational functions solely and isn’t an alternative to skilled medical recommendation, as your individual expertise will likely be distinctive. Use this text to information discussions along with your oncologist. Content material was generated with AI and reviewed by a human editor.
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