Observational studyClinical cancer research : an official journal of the American Association for Cancer Research2024
Tissue-Free Liquid Biopsies Combining Genomic and Methylation Signals for Minimal Residual Disease Detection in Patients with Early Colorectal Cancer from the UK TRACC Part B Study.
Observational study in Clinical cancer research : an official journal of the American Association for Cancer Research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04050345 (Tracking Mutations in Cell Free Tumour DNA to Predict Relapse in Early Colorectal Cancer), which is not on this map. Cited by 33 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Tracking Mutations in Cell Free Tumour DNA to Predict Relapse in Early Colorectal Cancer
Who cites it
33 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Predictive role of circulating tumor DNA based molecular residual disease for long-term outcomes in non-small cell lung cancer patients: a meta-analysis.World journal of surgical oncology · 2025Pooled it
- Circulating tumor DNA-guided de-escalation or escalation of adjuvant therapy in high-risk stage II and stage III colon cancer: the phase 2 PEGASUS trial.Nature cancer · 2026Trial
- Circulating tumor DNA-guided adjuvant therapy in locally advanced colon cancer: the randomized phase 2/3 DYNAMIC-III trial.Nature medicine · 2025Trial
- Review
- Paradigm Shifts in Perioperative Management of Colorectal Cancer: Personalization Based on Tumor Biology, Primary Site, and Recurrence Risk, and the Evolving Role of Organ Preservation.International journal of molecular sciences · 2026Review
- Circulating tumor DNA in gastrointestinal cancers: promise, pitfalls, and the path forward.EClinicalMedicine · 2026Review
- Article
- Insights into ctDNA assessment to detect minimal residual disease (MRD) in localized colorectal cancer.Scientific reports · 2026Article
- Circulating miR-184 and miR-206 as predictive biomarkers for early recurrence in HBV-related hepatocellular carcinoma: a prospective study.BMC gastroenterology · 2026Article
- Adjuvant chemotherapy in elderly colon cancer patients: when less may be more.Journal of gastrointestinal oncology · 2026Article
- Metastatic Odyssey: Decoding the Genomic Journey from Primary Colorectal Cancer to Disseminated Disease.Cancers · 2026Review
- Review
- Review
- Review
- Review
- ctDNA and immune biomarker testing for molecular residual disease surveillance and immune stratification in cancer.Frontiers in medicine · 2026Review
- The evolving role of ctDNA in colorectal cancer: guidance of adjuvant therapy or surveillance strategies?Translational gastroenterology and hepatology · 2026Article
- Systematic Pan-Cancer Analysis Identifies PHF6 as an Immunological and Prognostic Biomarker.Diagnostics (Basel, Switzerland) · 2025Article
- From residual risk to precision intervention: the evolving role of minimal residual disease in breast cancer management.Cancer biology & medicine · 2025Review
- Prognostic significance of circulating tumor DNA in non-metastatic colorectal cancer.Discover oncology · 2025Article
Corrections and comments
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Authors and funding
27 authors.
Funding
Abstract
purposeThe absence of postoperative circulating tumor DNA (ctDNA) identifies patients with resected colorectal cancer (CRC) with low recurrence risk for adjuvant chemotherapy (ACT) de-escalation. Our study presents the largest resected CRC cohort to date with tissue-free minimal residual disease (MRD) detection. EXPERIMENTAL
designTRACC (tracking mutations in cell-free tumor DNA to predict relapse in early colorectal cancer) included patients with stage I to III resectable CRC. Prospective longitudinal plasma collection for ctDNA occurred pre- and postsurgery, post-ACT, every 3 months for year 1 and every 6 months in years 2 and 3 with imaging annually. The Guardant Reveal assay evaluated genomic and methylation signals. The primary endpoint was 2-year recurrence-free survival (RFS) by postoperative ctDNA detection (NCT04050345).
resultsBetween December 2016 and August 2022, 1,203 were patients enrolled. Plasma samples (n = 997) from 214 patients were analyzed. One hundred forty-three patients were evaluable for the primary endpoint; 92 (64.3%) colon, 51 (35.7%) rectal; two (1.4%) stage I, 64 (44.8%) stage II, and 77 (53.8%) stage III. Median follow-up was 30.3 months (95% CI, 29.5-31.3). Two-year RFS was 91.1% in patients with ctDNA not detected postoperatively and 50.4% in those with ctDNA detected [HR, 6.5 (2.96-14.5); P < 0.0001]. Landmark negative predictive value (NPV) was 91.2% (95% CI, 83.9-95.9). Longitudinal sensitivity and specificity were 62.1% (95% CI, 42.2-79.3) and 85.9% (95% CI, 78.9-91.3), respectively. The median lead time from ctDNA detection to radiological recurrence was 7.3 months (IQR, 3.3-12.5; n = 9).
conclusionsTissue-free MRD detection with longitudinal sampling predicts recurrence in patients with stage I to III CRC without the need for tissue sequencing. The UK TRACC Part C study is currently investigating the potential for ACT de-escalation in patients with undetectable postoperative ctDNA, given the high NPV indicating a low likelihood of residual disease.
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