La positivité post-resection de l'ADNct-MRD dans le cancer colorectal de stade II/III identifie les patients...
Vue déterministe de l'entité source de la LJAM. L'autorité clinique demeure avec les ID de la source cités et l'état d'approbation de l ́examinateur.
| ID | BMA-CTDNA-MRD-POST-TREATMENT-CRC |
|---|---|
| Type | Pertinence thérapeutique |
| État | reviewed 2026-05-18 | actionability review required |
| Maladies | DIS-CRC |
| Sources | SRC-CIVIC SRC-ESMO-CRC-2024 SRC-NCCN-COLON-2025 |
Faits relatifs à l ' action en justice
| Biomarqueur | BIO-CTDNA-MRD-POST-TREATMENT |
|---|---|
| Variante | ctADN maladie résiduelle minimale — après la résection / après l'adjuvant CRC |
| Maladie | DIS-CRC |
| Niveau ESCAT | IIIA |
| Résumé des faits | 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. |
Notes
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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