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A ctDNA MRD blood test after surgery decides who gets more treatment and who is spared it.
This diagnostic-therapeutic pairing links MRD / molecular residual disease testing to the adjuvant decision, here with Immune checkpoint inhibitors: a ctDNA blood test after surgery decides who gets more treatment and who is spared it. Minimal / molecular residual disease (MRD) identifies the minority who will relapse, concentrating toxic therapy where it helps. In phase 3 IMvigor011, Atezolizumab given only to ctDNA-positive Bladder & urothelial cancer patients improved survival and was approved in 2026; in the randomised phase 2 DYNAMIC trial, ctDNA-negative Colorectal cancer patients safely skipped chemotherapy. It is being tested in Triple-negative breast cancer (TNBC) after KEYNOTE-522, in NSCLC and in breast cancer (ZEST, c-TRAK), often with Signatera.
After bladder removal, a blood test can now tell who needs immunotherapy and who can safely be spared it. This is the model for MRD-guided adjuvant therapy across cancers: treat the blood-positive, watch the blood-negative.
For stage II colon cancer, where most patients are cured by surgery alone, a blood test can identify the minority who benefit from chemotherapy and spare everyone else its side effects. It does not yet prove that treating ctDNA-positive patients improves survival compared with not treating them.
Shares ctDNA-triggered escalation in early TNBC, IMvigor011, DYNAMIC, Signatera.
Shares Formally qualify tumour-DNA blood tests as a surrogate endpoint for adjuvant trials, DYNAMIC: a blood test safely halved chemotherapy use after surgery for stage II colon cancer, DYNAMIC, Signatera.
Shares CIRCULATE-US, IMvigor011, DYNAMIC: a blood test safely halved chemotherapy use after surgery for stage II colon cancer, DYNAMIC.
Shares CIRCULATE-US, Signatera, ctDNA tests roadmap: from a curiosity in plasma to blood tests that decide treatment, Minimal / molecular residual disease (MRD).
Shares IMvigor011: using a blood test for leftover cancer to decide who gets immunotherapy after bladder surgery, IMvigor011, Signatera, ctDNA tests roadmap: from a curiosity in plasma to blood tests that decide treatment.
Shares CIRCULATE-US, DYNAMIC, Signatera, Minimal / molecular residual disease (MRD).
Shares DYNAMIC: a blood test safely halved chemotherapy use after surgery for stage II colon cancer, DYNAMIC, Signatera, ctDNA tests roadmap: from a curiosity in plasma to blood tests that decide treatment.
Shares DYNAMIC: a blood test safely halved chemotherapy use after surgery for stage II colon cancer, DYNAMIC, Signatera, ctDNA tests roadmap: from a curiosity in plasma to blood tests that decide treatment.