Updated results from the DYNAMIC III and PEGASUS trials put circulating tumor DNA at the center of adjuvant treatment strategy in colorectal cancer. Dr. Jonathan Mizrahi and Dr. Jun Gong explore whether ctDNA can move from a prognostic marker to a true tool for guiding therapy, helping identify which stage III and high-risk stage II patients need intensified treatment and which may safely avoid oxaliplatin-related neuropathy. Differences in trial design, patient populations, and testing platforms are unpacked to highlight how each study informs real-world use. Together, these suggest a future where adjuvant therapy is increasingly tailored to molecular risk rather than stage alone.
Contributors:
Dr. Jonathan Mizrahi is a medical oncologist with Ochsner Health in New Orleans, Louisiana.
Dr. Jun Gong is an oncologist at Cedars-Sinai in Los Angeles, California.
