Post-resection ctDNA-MRD positivity in stage II/III colorectal cancer identifies patients...
Vista determinista de la entidad fuente YAML. La autoridad clínica sigue con los ID de fuente citados y estado de firma del revisor.
| ID | BMA-CTDNA-MRD-POST-TREATMENT-CRC |
|---|---|
| Tipo | Relevancia terapéutica |
| Situación | reviewed 2026-05-18 | actionability review required |
| Enfermedades | DIS-CRC |
| Fuentes | SRC-CIVIC SRC-ESMO-CRC-2024 SRC-NCCN-COLON-2025 |
Hechos relativos a la posibilidad de adoptar medidas
| Biomarcador | BIO-CTDNA-MRD-POST-TREATMENT |
|---|---|
| Variante | ctDNA enfermedad residual mínima — postresección / CRC postreyuvante |
| Enfermedad | DIS-CRC |
| El nivel de ESCAT | IIIA |
| Resumen de las pruebas | Post-resection ctDNA-MRD positivity in stage II/III colorectal cancer identifies patients at very high recurrence risk (DYNAMIC trial — Tie 2022; GALAXY/CIRCULATE-Japan — Kotani 2023). Persistently negative ctDNA in stage II low-risk patients allowed adjuvant-chemotherapy de-escalation in DYNAMIC without an OS detriment. ctDNA-MRD-guided escalation (post-positive intensification) is being tested prospectively (BESPOKE, COBRA, CIRCULATE-US, ALTAIR). NCCN Colon 2025 acknowledges ctDNA-MRD as emerging/optional; not yet a category-1 trigger. ESCAT IIIA — evidence base substantial but not yet level-A actionability. |
Notas
STUB pending two-Co-Lead signoff. No post-treatment CRC surveillance Indication entity exists yet that ingests ctDNA-MRD status as a trigger (closest: future IND-CRC-POST-RESECTION-CTDNA-MRD-MONITORING). Until authored, indications: [] is intentional. Clinical use today: post-curative-resection serial draws at landmark (week 4-6) + every 3-6 months for 2-3 years. MRD-positive → multidisciplinary imaging re-evaluation; MRD-negative low-risk stage II → eligibility for chemo de-escalation per DYNAMIC paradigm (still trial-protocoled in most institutions). Engine must not auto-recommend adjuvant chemotherapy on ctDNA-MRD alone outside trial context — CHARTER §8.3.
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