Trial reportNature medicine2025
Circulating tumor DNA analysis guiding adjuvant therapy in stage II colon cancer: 5-year outcomes of the randomized DYNAMIC trial.
Trial report in Nature medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 95 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
95 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Postoperative ctDNA-Guided Adjuvant Therapy in Resected Colorectal Cancer: A Systematic Review and Meta-analysis of Prognostic Validity Versus Treatment-Decision Utility.Journal of gastrointestinal cancer · 2026Pooled it
- Prognostic value of baseline circulating tumor DNA levels in metastatic castration-resistant prostate cancer: a systematic review and meta-analysis.Frontiers in immunology · 2026Pooled it
- Research trends and hotspots of circulating tumor DNA in colorectal cancer: a bibliometric study.Frontiers in oncology · 2025Pooled it
- Tissue-Free Circulating Tumor DNA Assay and Patient Outcome in a Phase III Trial of FOLFOX-Based Adjuvant Chemotherapy (Alliance N0147).Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2026Trial
- Trial
- Circulating tumor DNA-guided adjuvant therapy in locally advanced colon cancer: the randomized phase 2/3 DYNAMIC-III trial.Nature medicine · 2025Trial
- Colorectal Cancer: Epidemiology, Risk Factors, Signaling Pathways, Clinical Features, Screening, Diagnosis, and Management.MedComm · 2026Review
- Site-specific limitations of ctDNA in PDAC surveillance: imaging detects pulmonary and local recurrence missed by liquid biopsy.Abdominal radiology (New York) · 2026Article
- Development of a Computational Histology Artificial Intelligence-Powered Prognostic Biomarker in Colorectal Cancer in The Cancer Genome Atlas.World journal of oncology · 2026Article
- Systemic health impact of cancer-associated extracellular vesicles and particles.Nature reviews. Cancer · 2026Review
- Review
- Salvage R0 Resection on Post-Recurrence Survival After Pulmonary Metastasectomy for Colorectal Cancer: A Multicenter Retrospective Study.Annals of surgical oncology · 2026Article
- Review
- Review
- 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 · 2026Article
- Article
- Emergency Surgery Independently Predicts Postoperative Recurrence in Patients with Pathologic T3N0M0 Colon Cancer: A Retrospective Single-Center Cohort Study.Current oncology (Toronto, Ont.) · 2026Article
- Perioperative ctDNA as a prognostic biomarker in endometrial cancer - the CODEC study.Translational oncology · 2026Article
- The role of circulating tumor DNA (ctDNA) to detect minimal residual disease in locally advanced gastroesophageal carcinoma: the BUTTERFLY study.ESMO gastrointestinal oncology · 2026Article
- Trajectory identification of high-risk subgroups after colorectal cancer surgery in patients with minimal residual disease: a single-center longitudinal study.Journal of gastrointestinal oncology · 2026Article
35 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
29 authors.
Funding
Abstract
Early data from the DYNAMIC study of circulating tumor DNA (ctDNA)-guided adjuvant chemotherapy (ACT) versus standard approach met its primary outcome demonstrating reduced ACT use without compromising 2-year recurrence-free survival (RFS) for stage II colon cancer. We report here other prespecified analyses of overall survival, ctDNA clearance and ctDNA level. At a median follow-up of 59.7 months, 5-year RFS was 88% and 87% with ctDNA-guided and standard management, respectively (difference 1.1%, 95% confidence interval -5.8% to 8.0%), and 5-year overall survival is similar (93.8% versus 93.3%, hazard ratio (HR) 1.05; P = 0.887). For treated ctDNA-positive patients, ctDNA clearance was observed at the end of ACT (EOT) in 35 out of 40 patients (87.5%). A higher than median postoperative tumor-derived mutant molecules per milliliter plasma was associated with worse 5-year RFS (HR 10.62; P = 0.005). For treated ctDNA-positive patients, post hoc analysis of ctDNA clearance at EOT assessed by a new assay that evaluated an average of 29 tumor-derived mutations per patient predicted for a favorable 5-year recurrence-free probability of 97% versus 0% for ctDNA persistence (P < 0.001). Mature DYNAMIC outcome data support a ctDNA-guided approach to ACT for stage II colon cancer, with potential to further risk stratify ctDNA-positive patients based on ctDNA burden and EOT results. Australian New Zealand Clinical Trials Registry Identifier: ACTRN12615000381583 .
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.