Circulating tumor DNA status and adjuvant chemotherapy after resection of colorectal liver metastases

The benefit of adjuvant chemotherapy (ACT) following curative resection of colorectal liver metastases (CLRM) is uncertain. A prospective analysis among patients with resected CLRM enrolled in the CIRCULATE-Japan GALAXY study evaluated the association between circulating tumor DNA (ctDNA)-defined molecular residual disease (MRD) and survival outcomes with ACT. In the upfront surgery cohort (n=191), MRD positivity 2 to 10 weeks after surgery was associated with worse disease-free survival and overall survival. In the neoadjuvant chemotherapy cohort (n=107), ACT was associated with improved survival outcomes among patients with positive MRD status but not among patients with negative MRD status. The authors conclude that ctDNA-defined MRD status may help refine postsurgical treatment strategies and support further evaluation of ctDNA-guided approaches in resected CRLM.