How would positive ctDNA results after 12 cycles of adjuvant FOLFOX affect your management for patients with colon cancer?  

I think the question should be, should you be testing ctDNA post adjuvant therapy? I do not want to order a test and then not know what to do with a positive result. I can imagine that this would cause fear and panic in certain patients.

For me the answer would be a clinical trial: We have the ACT-3 study open at Cornell alongside MGH (Dr. @Aparna R. Parikh's Study). It gives BRAF, HER2, Immunotherapy for MSI-High, and FOLFIRI or observation for ctDNA+ post adjuvant. ELI-002 vaccine study is an option open at multiple sites (Cor...

In addition to the excellent answers given, it is important to conceptually note that there is no current high level evidence for the utilization of ctDNA in Stage III colon cancer and limited data for Stage II, based on only the DYNAMIC data (Tie et al., PMID 35657320). The remainder of our knowled...

I think that in a motivated patient with positive ctDNA after adjuvant chemotherapy, evaluation for clinical trial is appropriate. In my opinion, I think that in the near future we will be discussing ctDNA rather than CEA as follow-up of our colon patients. In a patient in this setting who is not a ...