Predictive role of ctDNA in stage III colon cancer treated with celecoxib: post hoc analysis of CALGB/SWOG 80702

Observational studies have associated use of aspirin and coxibs with decreased recurrence and improved survival in patients with colon cancer. Randomized trial have not shown benefit across all patients. Post hoc analysis of the phase 3 CALGB/SWOG 80702 trial (celoxib versus placebo and 3 versus 6 months of adjuvant chemotherapy for stage III colon cancer) investigated the predictive value of postoperative circulating tumor DNA (ctDNA) for survival outcomes. The analysis, including 940 patients, found that ctDNA negativity was highly associated with improved survival. Patients with ctDNA positivity demonstrated a survival benefit with adjuvant celecoxib, whereas patients with ctDNA negativity did not. The authors conclude that these findings underscore the prognostic value of ctDNA and suggest it may help identify a subset of patients who benefit from adjuvant celecoxib alongside conventional chemotherapy.