Evidence map›Paper›PMID 42826364›Full record

Trial reportJCO precision oncology2026

Tumor-Free Circulating Tumor DNA in Node-Negative Rectal Cancers Undergoing Neoadjuvant Chemotherapy, Excision, and Observation in the Phase II NEO Trial (CO.28).

Jonathan M Loree, Emma Titmuss, Carl J Brown, Thereasa Rich, Kimberly Banks, Vallerie Gordon, Sunil Patel, Marianne Krahn, Antonio Caycedo-Marulanda, Manoj Raval and 4 more

Abstract readClinical Trial, Phase IIMulticenter Study
In one paragraph

Trial report in JCO precision oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Jonathan M LoreeBC Cancer, Vancouver, BC, Canada.ORCID 0000-0001-8189-2132
Emma TitmussBC Cancer, Vancouver, BC, Canada.ORCID 0000-0002-1993-6912
Carl J BrownSt Paul's Hospital, Vancouver, BC, Canada.ORCID 0000-0002-5368-3541
Thereasa RichGuardant Health, Palo Alto, CA.ORCID 0000-0003-3023-6930
Kimberly BanksGuardant Health, Palo Alto, CA.ORCID 0000-0002-1290-3114
Vallerie GordonSaskatchewan Cancer Agency, Saskatoon, SK, Canada.
Sunil PatelKingston Health Sciences Centre, Kingston, ON, Canada.
Marianne KrahnCancer Care Manitoba, Winnipeg, MB, Canada.
Antonio Caycedo-MarulandaNorthern Ontario School of Medicine, Sudbury, ON, Canada.ORCID 0000-0003-2387-5304
Manoj RavalSt Paul's Hospital, Vancouver, BC, Canada.
Dongsheng TuCanadian Cancer Trials Group, Kingston, ON, Canada.ORCID 0000-0003-4842-2184
Derek J JonkerThe Ottawa Hospital, Ottawa, ON, Canada.
Christopher J O'CallaghanCanadian Cancer Trials Group, Kingston, ON, Canada.
Hagen F KenneckeOregon Health Sciences Institute, Portland, OR.ORCID 0000-0002-3211-0656

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeOrgan preservation is a priority in early-stage rectal cancer as total mesorectal excision (TME) can reduce quality of life. The Canadian Cancer Trials Group CO.28 trial demonstrated that neoadjuvant chemotherapy followed by transanal excision was effective in patients with cT1-3, node-negative (N0) rectal cancer. Here, we explored circulating tumor DNA (ctDNA) from the trial as a potential future decision aid to guide TME. MATERIALS AND

methodsFifty-three of 58 patients (91.4%) from CO.28 had at least one sample available for ctDNA analysis using the Guardant Reveal epigenomic assay from the following time points: prechemotherapy, postchemotherapy, pretransanal endoscopic surgery (TES), and on follow-up at months 12, 24, and 36.

resultsctDNA was detected in 45.8% of patients before neoadjuvant chemotherapy. Detection was similar by T-stage (

conclusionctDNA testing identified cancers with inadequate response to chemotherapy in patients for whom TME was recommended. A tissue-free assay may enable faster turnaround times compared with tumor-informed assays and provide a tool to support organ preservation. Further exploration of these assays in early-stage rectal cancers is warranted.

Indexed as

Circulating Tumor DNANeoadjuvant TherapyRectal NeoplasmsAgedFemaleHumansMaleMiddle AgedCirculating Tumor DNA

Identifiers

PMID42826364
PMCPMC13657393

What OpenQuestion holds

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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.