The US National Comprehensive Cancer Network (NCCN) has issued guidelines stating that post-surgical circulating tumor DNA (ctDNA) is an emerging prognostic marker but does not recommend its use or the use of multigene assays to inform recurrence risk or adjuvant treatment for colon cancer patients. While ctDNA, multigene assays, and Immunoscore can provide additional recurrence risk information, the NCCN panel questions their value in predicting whether patients may benefit from additional chemotherapy.
The panel suggests the need for additional clinical trials to gather more data. This decision aligns with the European Society for Medical Oncology’s guidelines from 2020, and it may impact minimal residual disease testing using ctDNA in the future.