Circulating tumor DNA analysis guiding adjuvant therapy in stage II colon cancer.

Tie J, Cohen JD, Lahouel K, Lo SN, Wang Y, Kosmider S et al, for the DYNAMIC Investigators.

N Engl J Med 2022; 386: 2261-2272.

Patients were randomized to adjuvant chemotherapy depending on the presence of circulating DNA (n=302), or a control group (n=153). Fewer patients in the DNA group had chemotherapy (15 versus 28%), without compromising the rate of recurrence-free survival at a median of 37 months.

Comment: The optimal adjuvant treatment for surgically treated colorectal cancer continues to evolve. This study is another step forwards, and helps limit adjuvant therapy to those who will benefit most.