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.
- Open access
Circulating tumor DNA-guided therapy in high-risk colon cancer achieved a 2-year relapse-free rate of 88% in ctDNA-negative patients, but did not meet the predefined threshold.
- Why it matters: Accurate risk stratification is crucial to avoid unnecessary toxicity from standard adjuvant therapies and improve outcomes for colon cancer patients.
- What they did: A multicenter phase 2 trial enrolled 135 patients with resected high-risk colon cancer, using ctDNA status to guide adjuvant treatment duration and intensity, with primary focus on relapse-free survival at 2 years.
- The result: While the strategy showed similar disease-free survival to controls and reduced neurotoxicity, it did not meet the primary endpoint, underscoring the need for randomized trials and better approaches for ctDNA-positive disease.