Expert Point of View: Peter Paul Yu, MD, FACP, FASCO
ASCO EXPERT Peter Paul Yu, MD, FACP, FASCO, commented on these GALAXY trial findings. He noted the results of this current study and others planned will establish the role of circulating tumor DNA (ctDNA) monitoring for risk of recurrence and guidance for adjuvant therapy. Dr. Yu is Physician-in-Chief at the Hartford HealthCare Cancer Institute.
“At ASCO GI 2022, the GALAXY study reported that patients with ctDNA 4 weeks after resection of colon cancer had a … higher risk of recurrence compared with patients who had ctDNA-negative results. At the 2023 ASCO Breakthrough meeting, Watanabe and colleagues reported that BRAF V600E status and MSI status add additional discriminatory power for patient populations with positive and negative ctDNA status,” Dr. Yu stated.
Peter Paul Yu, MD, FACP, FASCO
“The ALTAIR and VEGA studies are examining the role of postoperative ctDNA studies in escalating or de-escalating strategies for adjuvant chemotherapy. Their findings will add to that of the DYNAMIC study in stage II colon cancer, which was published in 2022 in The New England Journal of Medicine,1” he continued.
“In the United States, ctDNA studies are not yet standard of care but are increasing in use, most often to monitor patients for recurrence off treatment. Perhaps the greatest potential for such tests will be in guiding the use and duration of adjuvant chemotherapy,” Dr. Yu said.
DISCLOSURE: Dr. Yu owns stock in Google, Apple, Microsoft, Amazon, and Danaher.
1. Tie J, Cohen JD, Lahouel K, et al: Circulating tumor DNA analysis guiding adjuvant therapy in stage II colon cancer. N Engl J Med 386:2261-2272, 2022.
Postoperative molecular residual disease detected by circulating tumor DNA (ctDNA) at 4 weeks after resection has emerged as the strongest prognostic risk factor for disease-free survival in patients with resected colorectal cancer. This finding was observed regardless of BRAF V600E status and...